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COUNSELING YOUNG CHINESE AMERICAN COUPLES FROM CHINA 


TO LIVE HAPPILY IN THE UNITED STATES 


A THESIS-PROJECT 
SUBMITTED TO THE FACULTY OF 
GORDON-CONWELL THEOLOGICAL SEMINARY 


IN PARTIAL FULFILLMENT OF REQUIREMENTS FOR THE DEGREE 
DOCTOR OF MINISTRY 


BY 

JOE WANG 


MAY 2017 



Copyright ©2017 by Joe Wang. All Rights Reserved. 



CONTENTS 


ACKNOWLEDGEMENTS iv 

ABSTRACT v 

Chapter 

1. THE PROBLEM AND ITS SETTING 1 

2. THEOLOGICAL FRAMEWORK 17 

3. LITERATURE REVIEW 31 

4. PROJECT DESIGN 47 

5. OUTCOMES 61 

BIBLIOGRAPHY 80 

VITA 84 


iii 



ACKNOWLEDGEMENTS 


First, I would like to thank my wife, Elaine, who has stayed with me throughout all the 
poor and rich years of our marriage. Her encouragement and support was and 
continues to be vital for my ministry and the DMIN program. Next, I thank my daughter, 
Lin-Chi Wang who has provided many insights and comments into my thesis. I also thank 
Peter Cooper, my dedicated editor. With him, I was able to meet the thesis 
requirements. Finally, I thank Dr. Pendleton and Dr. Mason who are not just great 
teachers in counseling, but also helpful mentors who advised me on my ministry 
challenges. 


IV 



ABSTRACT 


In recent decades, many young Chinese men and women arrived in the United 
States to pursue advanced degrees. Following graduation, many of them find jobs, get 
married and settle down in the United States. With the influence from traditional 
Chinese parents and past social changes in China, young Chinese American couples face 
life challenges from many fronts. This thesis lays out an integrated therapy approach to 
counseling young Chinese American couples, considering impacts from Chinese and 
American cultures and family genealogy to examine their life problems of old selves 
from outermost behavior to innermost perceptions, and using biblical methodology to 
help find sustainable solutions to their life problems in order to build new selves from 
innermost perceptions to outermost behavior. 


v 



CHAPTER ONE 


THE PROBLEM AND ITS SETTING 


In the past fourty years, more and more young students from China have been 
going to the USA to pursue higher education 1 . Many of these students find a job in the 
States after graduation and get married. When these couples have babies, they usually 
ask their parents to come to help raise the baby. However, due to the generational gap 
and cultural differences between the couples and their parents, conflicts between the 
two generations can emerge. 2 Counseling young Chinese American couples from China 
to live happily under the direct influence of their parents and indirect influence from 
changes in China is the focus of this thesis-project. The changes in China include 
traditional Chinese family values, the cultural revolution in 1966, the one child policy in 
1980, and the economic boom after 1978, which affected at least four generations. 
These changes happened after the end of the Chinese Civil War in 1950. 

Traditional Chinese Family Values 

According to China Resource, 

The traditional Chinese family is hierarchically organized, with the prime 
authority to be the most senior male who is responsible for the orderly 

1 ICEF, "Chinese Enrollment in the US Shifting Increasingly to Undergraduate Studies," posted 2015, accessed February 
12, 2017, http://monitor.icef.com/2015/05/chinese-enrolment-in-the-us-shifting-increasingly-to-undergraduate- 
studies/. 


2 Anna S. Lau, "Physical Discipline in Chinese American Immigrant Families: An Adaptive Culture Perspective", Cultural 
Diversity and Ethnic Minority Psychology, American Psychological Association 2010, Vol. 16, No. 3, 313-322 1099- 
9809/10/$12.00 DOI: 10.1037/a0018667. 


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management of the family. According to the tradition, the order is: (1) senior 
generations are superior to junior generations, (2) older people are superior to 
younger ones, and (3) men are superior to women. For example, the order 
between an adult son and his widowed mother would be the son who is the 
household head. 

Additionally, when a man is married, he brings his wife to live on his 
family estate. The marriage is a defining event in the life of a girl, and sentiment 
is great sorrow at leaving her girlhood home to assume her new status as a 
married woman. That is the time the girl is explicitly removed from the family of 
her birth and affiliated to her husband's family. 

Reverence is paid to ancestors which include husband's male ancestors 
and their wives, and wife's male ancestors and their wives. In popular belief, 
dead ancestors' continued living depend upon the sacrificial food by their male 
offspring, therefore the failure to produce male offspring is considered an 
immoral behavior or a great misfortune. The Chinese believe dead people 
without male descendants to look after them are potentially dangerous ghosts. 3 

Nevertheless, these traditional Chinese family values have changed in various 

degrees for families due to modernization and migration to urban city or overseas. 4 


Cultural Revolution 

In the fall of 1965, China's Communist leader Mao Zedong launched the Cultural 
Revolution (known in full as the "Great Proletarian Cultural Revolution"). Mao Zedong 
shut down the nation's schools, and mobilized the country's youth to attack party 
leaders whom Mao thought had embraced bourgeois values and lack of revolutionary 
spirit. Nevertheless, Mao's main purpose was to reassert his authority over the Chinese 
government. In the following months, this movement spread like a wild fire. The 


3 China Resource, "The Traditional Chinese Family & Lineage," posted 2011, accessed May 12, 2016, 
http://pages.ucsd.edu/~dkjordan/chin/familism.html. 

4 Marshall Jung, Chinese American Family Therapy: A New Model for Clinicians (International Phychotherapy Institute, 
1998), 96. 


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students formed paramilitary groups called the Red Guards and attacked and harassed 


members of China's elderly and intellectual population. 5 

Bai described the Cultural Revolution’s disruptive impact on the economy and 
education as follows: 

Besides the political upheaval, the Cultural Revolution was also a disastrous time 
for the country's economy, as regional governments pursued policies that were 
invariably antagonistic towards private business. 

For the country as a whole, the value of total production declined by 9.6 
percent in 1967, with industry harder hit than agriculture. The decline continued 
steadily in 1968, when the industrial output of the southern provinces of Henan, 
Hubei, and Hunan combined declined by 25 billion yuan. In southwest China, 
output was down by more than 41 percent; in Yunnan, the output value of state- 
owned industries dropped by almost two-thirds. 

The empirical results show large and negative efects of revolutionary 
intensity on economic outcomes, such as the extent of industrialization and per- 
capita output. These impacts are detectable more than thirty years later, with 
some beginning to decline at longer time horizons. For instance, an increase in 
reported deaths of 50 persons is estimated to have caused a 17% decrease in 
the fraction of population employed in industry in 1982. The magnitude of this 
efect is reduced to 11% by 1990. Both are significant at the 95% level of 
confidence. By 2000, the estimated magnitude is further reduced to 3%, and no 
longer statistically significant. 

The rural rustificaiton movement was not the only program that afected 
the educational opportunities of China's youth during this period. Starting in 1966, 
all primary schools in urban China were closed for 2-3 years, and secondary- and 
tertiary-level institutions were closed for much longer. Some primary and middle 
schools reopened in 1968-69, so those who would have completed primary 
school in 1966-68 were able to go on to high school and children aged 7-9 began 
primary school. However, teachers were not allowed to follow the standard 
curriculum, and instead students were asked to study Mao Zedong Thought and 
learn farming and manual labor. Those of normal graduation age for middle- or 
high- school were given diplomas even though they did not complete a traditional 
middle- or high-school education. High schools stopped admitting new students 
during 1966-72, and when they nally reopened, their curriculum focused on 
factory and farm work. 

Universities were closed from 1966 to 1970-71, although those who had 
entered university before the Revolution and had not completed their degrees 
were allowed to stay there without formal teaching until 1970-71. They were then 
given a university degree and assigned jobs. After 1970-71, universities began to 
admit students, with new admission criteria based on the political attitudes or 
family background of the students, which favored unskilled workers, peasants, 
soldiers, party cadres, or students whose parents were from these groups. 
Admission was not based on academic merit, and no high-school graduates were 


5 Directorate of Intelligence, "Mao's 'Cultural Revolution': Origin and Development", posted 2007, accessed February 
13, 2017, https://www.cia.gov/library/readingroom/docs/polo-14.pdf. 


3 



allowed to go to college directly. As in the lower-level schools, students in 
universities did not receive the education provided by a normal curriculum; 
instead political study was given emphasis. 

With its purported goals of tackling inequality and forestalling a capitalist 
restoration, the Great Proletarian Cultural Revolution was a catastrophic event 
for large sections of the population, especially members of the educated elite. All 
across China, because of their perceived lack of commitment to socialism, 
individuals with so-called bad class backgrounds (e.g. former landlords, rich 
peasants, intellectuals) were particularly at risk (Su (2011)). Existing estimates of 
the number of fatalities range from 250,000 to 1.5 million, while that of victims, 
including those imprisoned and otherwise persecuted, is closer to 30 million 
(Walder and Su (2003)). In addition to this targeted violence, there was 
widespread disruption to the functioning of government services, most notably 
the closure of schools and universities. Taken together, this has often led to the 
cohorts growing up during this period being labeled as China's lost generation 
(Chen (1999)). 6 

The Cultural Revelation was not just a political movement for Mao to get ride of 
his opponents, it severely damaged the education system and ruined the economic 
growth for that generation and the generations follows physically and mentally. 


One Child Policy 

In the early 1980s, China's population approached one billion 7 , and the Chinese 
government became concerned about the negative effect the population growth may 
have on its ambitious economic plan goals. Therefore, Chinese leader Deng Xiaoping 
decided to take a stronger action to control the population growth and the One Child 
policy was introduced in 1979. "The policy limits couples to one child. Fines, pressures 
to abort a pregnancy, and even forced sterilization accompanied second or subsequent 


6 Liang Bai, "Economic Legacies of the Cultural Revolution," posted 2015, accessed March 18, 2017, 
http://www.lse.ac.uk/economichistory/seminars/economichistory/papersl4-15/cultural-revolution.pdf. 

7 Worldmeters, China Population, posted 2017, accessed March 18, 2017, http://www.worldometers.info/world- 
population/china-population/. 

4 



pregnancies." Nevertheless, "Citizens living in rural areas and minorities living in China 


are not subject to the law.” 8 

The One Child Policy caused three major problems in China: first, it caused a 
skewed sex ratio; second, it caused the "4-2-1 Problem;" and, third, it caused the "little 
emperor syndrome." 

According to an article by Chen Wei discussing the sex ratios of births in China: 

The sex ratio of a newborn infant (between male and female births) in mainland 
China reached 117:100 and stabilized between 2000 & 2013. This ratio is 
substantially higher than the natural baseline for China, which ranges between 
103:100 and 107:100. It had risen from 108:100 in 1981—at the boundary of the 
natural baseline—to 111:100 in 1990. (Wei, 2005) according to a report by the 
National Population and Family Planning Commission, there will be 30 million 
more men than women in 2020, potentially leading to social instability, and 
courtship-motivated emigration. 

Because of a traditional preference for baby boys over girls, the one-child 
policy is often cited as the cause of China's skewed sex ratio... Even the 
government acknowledges the problem and has expressed concern about the 
tens of millions of young men who won't be able to find brides and may turn to 
kidnapping women, sex trafficking, other forms of crime or social unrest. 9 

The 4-2-1 problem caused by the one-child policy means that in many Chinese 

family, the only children will have to care for both of their parents and, sometimes, all 

four of their grandparents. According to Tsintolas, 

Due to technological advancements and improved healthcare, people are living 
longer and therefore the size of the aging population is growing (Dvorsky). The 
size of China's population aged sixty and above will grow by "100 million in just 
15 years (from 200 million in 2015 to over 300 million by 2030)" (Wang). This 
augmentation in the number of elderly people will lead to an ’increasing demand 
for services and expenditures related to health care,' the costs of which will fall 


8 Matt Rosenberg, "China's One Child Policy," posted 2017, accessed March 18, 2017, 
https://www.thoughtco.com/chinas-one-child-policy-1435466. 

9 CBC News, "Five Things to Know about China's One-Child Policy," posted 2015, accessed March 18, 2017, 
http://www.cbc.ca/news/world/5-things-to-know-about-china-s-l-child-policy-l.3294335. 


5 



upon China's only children (Wang). The one-child policy has created a situation 
in China in which there are too few young people to support a growing, aging 
population. 10 

As a result, the young Chinese people feels great burden on caring for their aging 
parents and grandparents physically, mentally and financially. 

For the "little emperor syndrome," Pappas states. 

Children born under China's one-child policy, which limits most urban families to 
a single child, are less trusting, more risk-averse and more pessimistic than 
children born before the policy went into action, a new study finds. The research 
in some ways confirms stereotypes in the Chinese media about "Little Emperor 
Syndrome," which is the idea that a generation of only children in the country is 
growing up coddled and unsocialized. The seeming personality changes could 
have real-world impacts, the researchers say, creating a relatively risk-averse 
generation that may hinder innovation. 11 

The one child policy has caused significant negative impact to that generation 
and the generations following in China, through gender imbalance, severe burden to 
support senior parents and grandparents and twisted personality of the children born in 
that era. 


Economic Boom 

In the past half century, China has modernized and the economy had a major 
boom 12 . "Modernization impacted family structure, relationships, values and beliefs. 
Families became nuclear as people became more mobile and as society became more 


10 Alexa Tsintolas, "4-2-1: A Smaller Young Population to Care for a Growing Older Population," posted 2013, accessed 
February 14, 2017, http://alexatsintolas.weebly.com/the-4-2-l-problem.html. 

11 Stephanie Pappas, "China's One-Child Policy Creates 'Little Emperors'" posted 2013, accessed February 14, 2017, 
http://www.livescience.com/26166-china-one-child-policy-changes-personalities.html. 

12 Tomas Hirst, A brief history of China's economic growth, posted 2015, accessed March 18, 2017, 
https://www.weforum.org/agenda/2015/07/brief-history-of-china-economic-growth/. 


6 



urban. Economic development provided employment opportunities outside of one's 


birthplace. Away from a kinship network, a nuclear family is less influenced and 
controlled by elder members in the extended family in fulfilling its traditional roles and 
obligation." 13 

Fenghecj states/'During this period, the middle class in China has grown from 
almost zero to 22.5 million and most of them have attained higher education and lived 
in first and second tiers cities." 14 Their low level of physical needs and safety are met. 
The middle level of emotional need and repect are mostly satisfied. But they are still 
pursuing the high level's meaning of life and personal dream actualization. 15 

From 2006 to 2008 in China, housing prices doubled, and the increase in living 
expenses shrunk the buying power of the middle class. Sadly, the situation has gotten 
worse since 2009, the housing price ballooned 10 times compared to 2006 in Shenzhen. 
For young people, when they consider their future, their choices are "escaping Beijing, 
Shanghai, Guangzhou and Shenzhen," or "Going aboard for an advanced degree" to seek 
better opportunities, socially and financially 16 . 


13 Anqi Xu, Yan Xia, The Changes in Mainland Chinese Families During the Social Transition: A Critical Analysis, posted, 
accessed March 18, 2017, http://digitalcommons.unl.edu/famconfacpub/91/. 

14 "'Tgigifi", posted 2016, accessed May 25, 2016, 

http://baike.baidu.com/subview/11734050/12098214.htm (The China city level is defined by First Fortune Weekly on 
10 indexes: brand density and volume, GDP, average income, university. Fortune 500, large company, airport, 
embassy and international air route). 

15 Fenghecj, "Tf Ti'!ftiSlT)4 5 / iE P/i't$'', posted 2016, accessed May 26, 2016, 

http://36kr.eom/p/5049938.html. 

16i rfc^1f Tcfs, ‘THiSSTS., posted 2010, accessed May 27, 

2016, http://www.djzhj.com/ltem/10153.aspx. 


7 



Fenghecj also states, "The middle class in China believes in globalization. 


freedom of choice, and market economy. But the current social situation is going the 
other direction since the social welfare system is not well established and goverment 
policy is not transparent." 17 Plus, the global trend turns to anti-globalization. The 
Populist party is gaining rising supoort and power in industrialized countries and low 
class citizens begin to violently express their anger which reflects in anti-globalization. 18 

If China's relationship with Western countries gets worse, and it denies the 
values of Western culture, it will be a big blow to the middle class who tend to treasure 
Western values. 19 Furthermore, if populist and anti-intellectual beliefs rise, 20 the middle 
class in China may feel they are against the main stream. 

With pressure from many fronts, middle class families in China encourage their 
children to study abroad and parents send their children to boarding school in China and 
overseas even when the children are in the middle school. 21 Middle class parents in 
China work very hard to support their children financially, but the children get less love 
and caring from their parents due to separation. This pattern repeats because the 
parents do not know how to show love to each other and their kids. Therefore, when 


17 Fenghecj, "ti 

18 Ronald F. Inglehart and Pippa Norris, "Trump, Brexit, and the Rise of Populism: Economic Have-Nots and Cultural 
Backlash," posted 2016, accessed March 18, 2017, 

https://research. hks. harvard. edu/publications/getFile.aspx?ld=1401 

19 Fenghecj, "t? 

°0 

Inglehart and Norris, "Rise of Populism." 

21 Fenghecj, I 


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the children grow up, they in turn do not know how to show love to others and feel 


helpless and fear toward marriage. 

An Integrated Approach 

With these direct and indirect influences in mind, the theoretical methodology 
for counseling young Chinese American couples that I adopted is an integrated 
approach: Attachment-Centered, Emotionally Focused, and Cognitive-Behavior Family 
Therapy. 


Attachment-Centered 

Humans need loving care from an early age in order to grow to be healthy adults. 

Lack of proper attachment during development can cause various mental and physical 

illness. 22 Therefore, many behavioral and relational problems of a person can be 

explained by the attachment-centered theory. 

Bowlby states that interpersonal attachment starts from the infant-mother tie, 

Bowlby, a psychoanalyst in the tradition of object relations theory, not only 
opposed the view of interpersonal ties as secondary acquisitions which have 
developed on the basis of gratification of primary drives, but urged an updating 
of psychoanalytic instinct theory to a view congruent with present-day biology. 
The infant-mother tie is based on a number of species-characteristic behavioral 
systems which, from the beginning, are activated or terminated by classes of 
stimuli most likely to emanate from other persons, and which facilitate proximity 
and interaction of infant and mother. 23 


22 Laura E. Berk, Child Development, 9/e. 

23 Mary Ainsworth, "Object Relations, Dependency, and Attachment: A Theoretical Review of the Infant-Mother 
Relationship," Child Development 40 (1996): 969-1025. 


9 



Not just Bowlby emphasizes the infant-mother tie, Atwood also states. 


Because of the diversity of attachment behavior and its differential arousal in 
different situations, there can be no simple criterion of attachment. Bowlby 
suggests that five main classes of behavior should be considered in any attempt 
to assess the attachment behavior of a child: (a) behavior that initiates 
interaction, such as greeting, approaching, touching, embracing, calling, 
reaching, and smiling; (b) behavior in response to the mother's interactional 
initiatives that maintains interaction (the above behaviors plus watching); (c) 
behavior aimed to avoid separations, such as following, clinging, and crying; (d) 
exploratory behavior, as it is oriented with reference to the mother; and (e) 
withdrawal or fear behavior, especially as it is oriented with reference to the 
mother. 24 

Furthermore, Ainsworth explains what attachment is: 

"What do we mean by attachment? I lean to a definition which equates love and 
attachment. If such a definition is accepted, it is obvious that at the present time 
there is no set of indices in terms of which strength or intensity of attachment 
can be assessed, for all behavioral indices are affected by ambivalence, anxiety, 
stress, separation, and isolation. 

Gewirtz, in an attempt to integrate the concepts of dependency and attachment, 
suggests that attachment is focused and directed toward one or a few specific 
figures, whereas dependency is generalized toward a class of persons. 
Immediately appealing though this distinction may be, it seems unlikely that this 
is the focal difference between dependency and attachment." 25 

As these authors state, healthy attachment is vital for child development. For 

Chinese people born in the Cultural Revolution era, many were not raised by their 

parents, but by grandparents or relatives. These children felt neglected or abandoned. 26 

To the contrary, many children born during the One Child Policy era were over-indulged 


24 Ainsworth, "Object Relations, Dependency, and Attachment," 969-1025. 

25 Ainsworth, "Object Relations, Dependency, and Attachment," 969-1025. 

26 Liang Bai, "Economic Legacies of the Cultural Revolution" 


10 



by their parents. 27 These two extreme developmental environments both raise children 


with unhealthy attachment behavior. The attachment-centered theory allows the 

therapist to examine the attachment between parent-child and husband-wife to 

understand the complex unhealthy interrelationship. 

In Bowlby's terms, attachment provides a person with a secure base - the ability 
to regulate emotions and the confidence to explore the world. When attachment 
is threatened, the first response is likely to be anger and protest, followed by 
some form of clinging, which eventually gives way to despair. Finally, if 
attachment figures do not respond, detachment and isolation will occur. 28 

With the attachment-centered approach, the therapist starts from the current 

attachment related problem behavior to understand the underlying feelings and 

thoughts. Then, he begins to rebuild a future healthy attachment pattern by changing 

the client's thinking first and helping him or her to have positive feelings and behaviors 

from the weekly assignment of each session. 


Emotionally Focused 

For a therapist to understand and provide solutions to a relational conflict. 
Emotionally Focused Therapy (EFT) 29 allows the therapist to see through outer emotions 
and dig into the inner emotions. 

Johnson states. 

Emotionally Focused Therapy (EFT) is integrative; it looks within and between. It 
integrates an intrapsychic focus on how individuals process their experience. 


27 Pappas, "China's One-Child Policy Creates 'Little Emperors.’" 

28 Michael Nichols, Michael The Self in the System (New York, NY: Brunner-Mazel, 1987), 147. 

29 ICEEFT, "WHAT IS EFT," posted 2007, accessed March 18, 2017, http://www.iceeft.com/index.php/about-us/what- 
is-eft. 


11 



particularly their key attachment-oriented emotional response, with an 
interpersonal focus on how partners organize their interactions into pattern and 
cycles. It considers how systemic pattern and inner experience and sense of self 
evoke and create each other. 

EFT expands experience and interactions. The first goal of therapy is to 
access and reprocess the emotional responses underlying each partner's often 
narrow and rigidly held interactional position, thereby facilitating a shift in these 
positions toward accessibility and responsiveness, the building blocks of secure 
bonds. The second goal of therapy is to create new interactional events that 
redefine the relationship as a source of security and comfort for each of the 
partners. 30 

For example, when counseling a couple, after the husband has revealed he had 
an affair, the therapist may follow the 9 EFT counseling stages: 

1. Identify the relational conflict issues. 

2. Identify the negative relational cycles. 

3. Access the un-acknowledged attachment-oriented emotions underlying the 
interactional positions each partner takes in this cycle. 

4. Reframe the problem to the couple in terms of this cycle. 

5. Promote identification with disowned attachment needs. 

6. Promote each partner's acceptance of other's experience. 

7. Facilitate the expression of needs and wants. 

8. Facilitate the emergence of new solutions to old problems. 

9. Consolidate new positions and cycles of attachment behaviors. 

For the injured wife, the therapist may carry out the resolution of attachment 
injuries: 


30 S.M. Johnson, The Practice Of Emotionally Focused Couple Therapy: Creating Connection (New York, NY: Brunner- 
Routledge, 2004), 9-10. 


12 



1. The injured spouse stays in touch with the injury and articulates its impacts. 

2. The partner hears and understands the significance of injurious event as a reflection 
of her importance to the injured spouse rather than as a reflection of his 
inadequacy/insensitivity. 

3. The injured spouse grieves. 

4. The partner acknowledges his responsibility. (Johnson, 2004) 31 

When a young husband and wife are the only children in their respective 
families, lack of social skills and emotion regulation due to the "little emperor" condition 
may cause conflict. These couple's parents may also still keep some traditional Chinese 
family values which makes the four-way interaction even more difficult. Emotionally 
Focused Therapy allows the couple to reveal their outer and inner emotions hidden in 
the behavior: 

Emotionally focused couples therapy works on two levels in succession - 
uncovering the hurt and longing beneath defensive expressions of anger and 
withdrawal and then helping couples understand how these feelings are played 
out in their relationship. To begin with, the therapist acknowledges each other's 
immediate feelings - hurt and anger, say - to make them feel understood. 32 

EFT allows the therapist to work effectively with the client to go through 

emotion exploration, relief and regulation. 


31 Johnson, Emotionally Focused Couple Therapy. 

32 Nichols, The Self in the System, 157. 


13 



Cognitive-Behavioral 


Misperception based on partial fact or bias could cause a negative emotion 
which produces abnormal behavior. 33 ln order for the therapist to help the client seeking 
a solution for an old behavioral or relational problem, Cognitive-Behavioral therapy 
(CBT) 34 is a collaboration between a therapist and a client to discover the dysfunctional 
interpretation and replace it with a functional interpretation. 

Corsini states. 

Cognitive therapy is based on a theory of personality that maintains that people 
respond to life events through a combination of cognitive, affective, 
motivational, and behavioral responses. These responses are based in human 
evolution and individual learning history. The cognitive system deals with the 
way individuals perceive, interpret, and assign meanings to events. It interacts 
with the other affective, motivational, and physiological systems to process 
information from the physical and social environments and to respond 
accordingly. Sometimes responses are maladaptive because of misperceptions, 
misinterpretations, or dysfunctional, idiosyncratic interpretations of situations. 35 

The overall strategies of cognitive therapy involve primarily a 
collaborative enterprise between the patient and the therapist to explore 
dysfunctional interpretations and try to modify them. This collaborative 
empiricism views the patient as a practical scientist who lives by interpreting 
stimuli but who has been temporarily thwarted by his or her own information¬ 
gathering and integrating apparatus (cf. Kelly, 1955). The second strategy, guided 
discovery, is directed toward discovering what threads run through the patient's 
present misperceptions and beliefs and linking them to analogous experiences in 
the past. Thus, the therapist and patient collaboratively weave a tapestry that 
tells the story of the development of the patient's disorder. 36 


33 Robert Jervis, "Hypotheses on Misperception," World Politics 20, No. 3 (Apr., 1968), pp. 454-479. 

34 Aaron T. Beck, "What Is Cognitive Behavior Therapy (CBT)?" posted 2016, accessed March 18, 2017, 
https://www.beckinstitute.org/get-informed/what-is-cognitive-therapy/. 

35 R.J. Corsini and D. Wedding, Current Psychotherapies: Theories and Practice. 9th ed. (Canada: Brooks/Cole, 2010), 
276. 

36 Corsini and Wedding, Current Psychotherapies, 111. 


14 



Cognitive Behavioral Therapy is based on the belief that the event itself does not 


cause abnormal behavior. It is the perception of the event that directs the reaction. 
Cognitive Behavioral techniques help clients to explore their behavior patterns, outer 
and inner feeling and beliefs, and affect a person's thoughts with more realistic and 
biblical thoughts, thus decreasing emotional distress and self-defeating behavior. 37 

For counseling young Chinese American couples, understanding their 
perceptions and events from the Chinese culture is a critical first step in order to help 
them to live happily in America. Cognitive Behavioral Therapy is an effective therapy to 
achieve this goal. 38 


Family Therapy 

Because an individual is raised and developed in a family, the influence of a 
family on an individual can be significant. Nichols compares individual therapy and 
family therapy as follows. 

Individual psychotherapy and family therapy each offer an approach to 
treatment and a way of understanding human behavior. Both have their virtues. 
Individual therapy provides the concentrated focus to help people face their 
fears and learn to become more fully themselves. Individual therapists have 
always recognized the importance of family life in shaping personality, but they 
have assumed that these influences are internalized and that intrapsychic 
dynamics become the dominant forces controlling behavior. Treatment can and 
should, therefore, be directed at the person and his or her personal makeup. 
Family therapists, on the other hand, believe that the dominant forces in our 


37 Lynn K. Jones, Emotionally Focused Therapy With Couples — The Social Work Connection, posted 2009, accessed 
March 18, 2017, http://www.iceeft.com/Summaryarticle.pdf 

38 Chang, D. F., Hung, T., Ng, N., Ling, A., Chen, T., Cao, Y., & Zhang, Y, "Taoist cognitive therapy: Treatment of 
generalized anxiety disorder in a Chinese immigrant woma," Asian American Journal Of Psychology 7(3), 205-216; 
Hwang, W., Myers, H. F., Chiu, E., Mak, E., Butner, J. E., Fujimoto, K., & ... Miranda, J., "Culturally adapted cognitive- 
behavioral therapy for Chinese Americans with depression: A randomized controlled trial," Psychiatric Services 66(10), 
1035-1042; Hsieh, A. L., & Bean, R. A., "Understanding familial/cultural factors in adolescent depression: A culturally- 
competent treatment for working with Chinese American families," American Journal Of Family Therapy 42(5), 398- 
412. 


15 



lives are located externally, in the family. Therapy, in this framework, is directed 
at changing the organization of the family. When family organization is 
transformed, the life of every family member is altered accordingly. This last 
point—that changing a family changes the lives of its members—is important 
enough to elaborate. Family therapy isn't predicated merely on changing the 
individual patient in context. Family therapy exerts change on the entire family; 
therefore, improvement can be lasting because each family member is changed 
and continues to exert synchronous change on other family members. 39 

For example, "A recent longitudinal study of a community cohort...found that 

lack of parental affection or nurturing (i.e., emotional neglect) predicted the 

development of several DSM-IV personality disorders in adulthood, including schizoid 

and avoidant personality disorders." 40 

To effectively counsel a young Chinese American couples, family therapy is a 
must in order to understand the intertwining causality among family members, 
especially between parent and child. Family structure and genogram among multi¬ 
generations may provide the therapist insight and valuable information to understand 
the complete behavioral interactions. 

Chapter 1 presents the problem of the thesis through Traditional Chinese Family 
Values, Cultural Revolution, On Child Policy, and Economic Boom. Its setting is An 
Integrated Counseling Approach of Attachment Centered, Emotionally Focused, 
Cognitive Behavioral Family Therapy. Chapter 2 thooughly explores Theological 
Framework. 


39 Nichols, Family Therapy, 6. 

40 P.H. Blaney and T. Millon, Oxford Textbook of Psychopathology, 2nd Ed (New York, NY: Oxford University Press, 
2008), 596. 


16 



CHAPTER 2 


THEOLOGICAL FRAMEWORK 


The Nature of Human and the Duty of the Couple/Family 

In God's creation, humankind is special because humans are made in God's 
image. Yet, because God is invisible and formless, the meaning of "the image of God" 
has resulted in many discussions throughout the history of the church. Because the 
image of God does not have a physical likeness, it may be God's attributes and 
personality from the breath of life that God breathed into Adam's nostrils. 1 

Beck's view on imago Dei is, "The human person shares God's communicable 
attributes (including kindness, mercy, and love) but does not share God's 
incommunicable attributes tributes (such as self-existence, eternality, and 
immutability). The human person thus bears resemblance to God only in a secondary 
sense." 2 He further states, "Moreover, it must be emphasized that male and female 
humans are image and likeness of God (Gen. 1:27). Their common creation as imago Dei 
guarantees the personal and spiritual equality of the sexes, while allowing for their 
complementarity psychologically and functionally." Male and female both inherit imago 
Dei from God equally. Both genders have the same attributes. 


1 Genesis 2:7. 


2 J. Beck and B. Demarest, The Human Person in Theology and Psychology: A Biblical Anthropology for the Twenty-first 
Century (Grand Rapids, Ml: Kregel, 2006), Loc 1548. 


17 



The duties for humankind that God created are, "Be fruitful and increase in 


number; fill the earth and subdue it. Rule over the fish of the sea and the birds of the air 
and over every living creature that moves on the ground." 3 God's original intention and 
wishes for humans are to have many offsprings and to manage wisely and effectively 
the creation on the earth, in the sea and air. 

Marriage Includes a Man and a Woman 

In God's original design, in order for human to be fruitful and multiply, God 
created man and woman. So, after God gave Adam life, he said, "It is not good for the 
man to be alone. I will make a helper suitable for him." 4 The family started from a 
couple including a husband and a wife. The wife is the helper for the husband since it is 
not good for the husband to be alone doing everything. Wife and husband are a 
complement to each other and have different role and function in a family. The 
relationship of husband and the wife is very intimate since wife is bone of his bones, and 
flesh of his flesh. 5 

Husband and wife are indispensable to each other and dependent on each other. 
The natural need for man is respect and for woman is love. Therefore, the apostle Paul 
says, "wives should submit to their husbands in everything." 6 And "husbands ought to 


3 Genesis 1:28. 

4 Genesis 2:18. 

5 Genesis 2:23. 

6 Ephesians 5:24. 


18 



love their wives as their own bodies." 7 God states, "For this reason a man will leave his 


father and mother and be united to his wife, and they will become one flesh." 8 Paul also 
says, "In the Lord, however, woman is not independent of man, nor is man independent 
of woman. For as woman came from man, so also man is born of woman. But everything 
comes from God." 9 


Relationship between Husband and Wife 

Therefore, after a man is married, he should be independent physically, 
mentally, and financially from his parents and join with his wife as one flesh. 10 In God's 
design, the attachment between husband and wife is very intimate and strong. The 
relationship of husband and wife is like Christ and the church. As Jesus is the head of the 
church, the husband is the head of his wife, the wife submits herself unto her own 
husband. The husband loves his wife as Christ loved the church and gave himself for it. 
So, the husband's love toward his wife is agape, the unconditional sacrificial love. 

In a marriage, if the love between a husband and a wife is phileo/eros, 
conditional love, then when the conditions to support the love disappears, the love 
disappears also. Christian couples should be in Christ and let God's agape love fill into 


7 Ephesians 5:28. 

8 Genesis 2:24. 

9 1 Corinthians 11:11-12. 

10 Genesis 2:24. 


19 



them fully; so that the love between a couple would transform from phileo/eros to 
agape and sustain the marriage in all circumstances. 

Beyond the marriage relationship. Beck states, "The following Old Testament 
Scriptures (Genesis 1:27-28) demonstrate that the covenant of marriage is the first 
human relationship God created, as well as the foundation of a well-ordered and 
healthy society." 11 He also states, "The Bible, in general, views the human person 
concretely and existentially-as he or she lives in relation to God, family, other persons, 
and the wider world." 12 Human relationship starts in the marriage, then extend to the 
family and society which demonstrates that the human is born in need of various 
relationships. 


Relationship between Parents and Children 

As for the children in the family, "Children, obey your parents in everything, for 
this pleases the Lord." 13 As for the father in the family, "Fathers, do not embitter your 
children, or they will become discouraged." 14 When "The righteous man leads a 
blameless life; blessed are his children after him." 15 As for the mother in the family, "She 
brings him good, not harm, all the days of her life. She gets up while it is still dark; she 


11 Beck and Demarest, Human Person in Theology and Psychology, Loc 3336. 

12 Beck and Demarest, Human Person in Theology and Psychology, Loc 1198. 

13 Colossians 3:20. 

14 Colossians 3:21. 

15 Proverbs 20:7. 


20 



provides food for her family and portions for her servant girls. Her children arise and call 


her blessed; her husband also, and he praises her ." 16 Besides, when husband and wife 
work together, they will produce much better results. "Two are better than one, 
because they have a good return for their work: If one falls down, his friend can help 
him up. But pity the man who falls and has no one to help him up !" 17 This is the biblical 
family structure, subsystems and boundary in God's original design. 

Besides, God's mercy and punishment acts may pass from parents to children 
based on parents' behavior. God is "maintaining love to thousands, and forgiving 
wickedness, rebellion and sin. Yet he does not leave the guilty unpunished; he punishes 
the children and their children for the sin of the fathers to the third and fourth 
generation ." 18 


God's Punishment on Adam and Eve's Original Sin 

After God created Adam, "The Lord God took the man and put him in the Garden 
of Eden to work it and take care of it. And the Lord God commanded the man, 'You are 
free to eat from any tree in the garden; but you must not eat from the tree of the 
knowledge of good and evil, for when you eat of it you will surely die .'" 19 But Adam and 
Eve ate the fruit from the tree of the knowledge of good and evil. While they did not die 


16 Proverbs 31:12,15,18. 

17 Ecclesiastes 4:9-10. 

18 Exodus 34:7. 

19 Genesis 2:15-17. 


21 



physically, they died spiritually because they were expelled by God from the garden of 


Eden and lost the bonding with God. 

Before they were expelled, God announced his punishment to Adam and Eve. He 
said to Eve, "I will greatly increase your pains in childbearing; with pain you will give 
birth to children. Your desire will be for your husband, and he will rule over you ." 20 
Thereafter, the center of life for the mother became her children and husband. The 
mother suffered from childbearing and giving birth, and raising children consumed the 
majority of her time and energy. In addition, the wife desired the husband's full 
attention and love. When the wife is in doubt of the husband's provision, every gesture 
and action of the husband would control the wife's feeling. 

For Adam, the punishment from God was, "Because you listened to your wife 
and ate from the tree about which I commanded you, 'You must not eat of it,' Cursed is 
the ground because of you; through painful toil you will eat of it all the days of your life. 
It will produce thorns and thistles for you, and you will eat the plants of the field. By the 
sweat of your brow you will eat your food until you return to the ground, since from it 
you were taken; for dust you are and to dust you will return ." 21 Since then, making a 
living became the center of life for man which occupies all of his energy and time. For 
centuries, a job for man means the most important thing in life because it does not only 
guarantee the physical supply for the living of his family, it is also the foundation of his 
self-esteem. 

20 Genesis 3:16. 

21 Genesis 3:17-19. 


22 



How to Transform from Old Self to New Self 


After the Fall of Adam and Eve, they were spiritually dead and their spiritual 

connection with God was cut off. But what happened to the image of God in humans? 

According to Beck, "The evidence leads to the conclusion that the imago Dei in sinners is 

deformed and degraded but not destroyed." 22 How could the imago Dei of human and 

the spiritual connection between man and God be restored and resumed? "For God so 

loved the world that he gave his one and only Son, that whoever believes in him shall 

not perish but have eternal life." 23 Once a sinner accepts Jesus as his Lord and believes 

Jesus was raised from the dead, the sinner will have eternal life. Beck states, "By 

personally appropriating the new life Christ offers, humans experience a renewal of 

their capacities and functioning." 24 Once a sinner is saved, the spiritual connection 

between him and God is resumed right away. The imago Dei in him is restored gradually 

in Christ. Beck has described the process: 

The human person is not the ultimate image-bearer of God; Jesus Christ is (2 
Cor. 4:4; Col. 1:15). By entering our time and space, the Son of God has given 
visible demonstration of what God is like (John 1:18; 14:9). God's purpose for 
His twice-born children is that they should "be conformed to the likeness of his 
Son" (Rom. 8:29). Thus through the new birth and lifelong long "imitation of 
Christ" (Thomas a Kempis [c. 1379-1471]), believers are being shaped into the 
likeness of Christ, the perfect image of God. The fact of the human being's 
creation in God's likeness is stated in the first page of the Bible; but not until the 
revelation of God's Son and His redeeming work did the full implications of the 
human person's resemblance to God become clear. 25 


22 Beck and Demarest, Human Person in Theology and Psychology, Loc 2593. 

23 John 3:16. 

24 Beck and Demarest, Human Person in Theology and Psychology, Loc 2601. 

25 Beck and Demarest, Human Person in Theology and Psychology, Loc 1548. 


23 



The Apostle Paul described in great detail the transformation process from old 


self to new self in the Romans 6-8. 


Romans 6: Old Self Died! 

Romans 6:3-7 clearly states when our old self would die and why our old self 
needs to die: 

Or don't you know that all of us who were baptized into Christ Jesus were 
baptized into his death? We were therefore buried with him through baptism 
into death in order that, just as Christ was raised from the dead through the 
glory of the Father, we too may live a new life. If we have been united with him 
like this in his death, we will certainly also be united with him in his resurrection. 
For we know that our old self was crucified with him so that the body of sin 
might be done away with, that we should no longer be slaves to sin--because 
anyone who has died has been freed from sin. 

But in reality, how can the old self die? In order for the old self to die, the 
believer needs to do two things: 1) all the old wounds need to be healed by God. If the 
believer was hurt by someone, forgive this person before God and let the hurt go; 2) all 
old debts need to be paid off. If the believer has hurt someone, the believer must admit 
the mistake, seek for forgiveness before God and that person, and pay the ransom; and 
3) choose to follow God as Lord and live a righteous life. 


Romans 7: Otherwise What a Wretched Man I Am! 

If the old self of a believer is not fully dead, or partially dead, when the believer 
receives signals from the outside world, the brain will process the signal the old way 
which causes the same old behavior to appear. If the old self is not dead, even though 


24 



the believer has the Holy Spirit in his/her heart as promised by Jesus, the battle would 


be fierce. Paul knew this struggle clearly as he described in Romans 7:18, 22-25, 

I know that nothing good lives in me, that is, in my sinful nature. For I have the 
desire to do what is good, but I cannot carry it out. For in my inner being, I 
delight in God's law; but I see another law at work in the members of my body, 
waging war against the law of my mind and making me a prisoner of the law of 
sin at work within my members. What a wretched man I am! Who will rescue me 
from this body of death? Thanks be to God--through Jesus Christ our Lord! So 
then, I myself in my mind am a slave to God's law, but in the sinful nature a slave 
to the law of sin. 

Most of the problems in Chinese American marriage that I observed or 
counseled were initially caused by different or conflict preferences and ways of doing 
things which were part of each spouse's old self. Even for Christians, a few were aware 
of the teaching of the necessity of the death of old self in Romans 6. Nevertheless, they 
accepted without hesitation my explanation that old self is the root cause of their 
conflicts. Also after counseling, each client was willing to begin to shift some of the 
blame of his/her marriage problems from the spouse to self. 

This theological concept fits well in EFT which provides a quick and direct remedy 
on couple's attachment-oriented emotional response and pattern and cycles of their 
interactions. So that their interactions can start to be redefined as a source of security 
and comfort for each of the partners in the marriage. 


Romans 8: New Self Lives! 

Paul knew that through Christ the believer can be freed and wins the battle 
against the flesh. As he stated the reasons in Romans 8:1-4, 11: 


25 



Therefore, there is now no condemnation for those who are in Christ Jesus, 
because through Christ Jesus the law of the Spirit of life set me free from the law 
of sin and death. For what the law was powerless to do in that it was weakened 
by the sinful nature, God did by sending his own Son in the likeness of sinful man 
to be a sin offering. And so he condemned sin in sinful man, in order that the 
righteous requirements of the law might be fully met in us, who do not live 
according to the sinful nature but according to the Spirit. And if the Spirit of him 
who raised Jesus from the dead is living in you, he who raised Christ from the 
dead will also give life to your mortal bodies through his Spirit, who lives in you. 

The key for the new self to live is for the believer to "love God," because in all 

things, God works for the good of who love him. From Romans 8:17-30, Paul wanted us 

to know that every day, believers live in suffering, in weakness and in growth and he 

encouraged us to work on three fronts. 


Endure patiently 26 

Romans 8:17 reminds us, "Now if we are children, then we are heirs-heirs of 
God and co-heirs with Christ, if indeed we share in his sufferings in order that we may 
also share in his glory." When we are willing to suffer the same suffering as Christ did, 
we will have the same glory as he had. 

But how did Jesus suffer and become glorified? Philippians 2:5-11 describes well 

Jesus' suffering and glory and how Christ suffered and became glorified: 

Your attitude should be the same as that of Christ Jesus: Who, being in very 
nature God, did not consider equality with God something to be grasped, but 
made himself nothing, taking the very nature of a servant, being made in human 
likeness. And being found in appearance as a man, he humbled himself and 
became obedient to death -- even death on a cross! Therefore God exalted him 
to the highest place and gave him the name that is above every name, that at 
the name of Jesus every knee should bow, in heaven and on earth and under 


26 Romans 8:17-25. 


26 



the earth, and every tongue confess that Jesus Christ is Lord, to the glory of God 
the Father. 

If we hope for those invisible future glories as Christ has, in the present suffering, 

we would be sustaining the suffering willingly. Therefore, "We share in his sufferings in 

order that we may also share in his glory." But what kind of suffering shall we endure? 

Adam and Eve committed the sin, they were expelled from the Garden of Eden 

and entered into a corrupt world ruled by their king, Satan. Therefore, human 

constantly faces "the cravings of sinful man, the lust of his eyes and the boasting of 

what he has and does. 27 Adam and Eve found that life was much tougher than before 

due to God's punishment, which was the consequence of the sin they committed. 

Paul described the struggle and hope of believers in Romans 8:20-25 in detail: 

For the creation was subjected to frustration, not by its own choice, but by the 
will of the one who subjected it, in hope that the creation itself will be liberated 
from its bondage to decay and brought into the glorious freedom of the children 
of God. We know that the whole creation has been groaning as in the pains of 
childbirth right up to the present time. Not only so, but we ourselves, who have 
the firstfruits of the Spirit, groan inwardly as we wait eagerly for our adoption as 
sons, the redemption of our bodies. For in this hope we were saved. But hope 
that is seen is no hope at all. Who hopes for what he already has? But if we 
hope for what we do not yet have, we wait for it patiently. 

The above paragraph describes believers who realize that the seeking of worldly 

treasure is in vain, then their hopes will be released from the control of corruption and 

they will enjoy the freedom and glory as God's children as he will come to seek Truth. 

Then, what is it like to be a Christian? Christians who do not live according to the 

sinful nature but according to the Spirit still "groan inwardly as we wait eagerly for our 


27 1 John 2:16. 


27 



adoption as sons, the redemption of our bodies." 28 "Our adoption as sons" means the 
adoption as God's children will be fully fulfilled at Jesus' second coming. "The 
redemption of our bodies" means the resurrection of our bodies will be realized during 
the end day when "the perishable has been clothed with the imperishable, and the 
mortal with immortality." (1 Corinthians 15:54) Therefore, we need to wait patiently in 
hope. Who endure to the end will be saved! 

But while we, as Christians, are waiting, we feel helplessness and weakness. 
What can we do? Paul told us in Romans 8:26-27 that the Holy Spirit would help us 
when we are in this situation, "In the same way, the Spirit helps us in our weakness. We 
do not know what we ought to pray for, but the Spirit himself intercedes for us with 
groans that words cannot express. And he who searches our hearts knows the mind of 
the Spirit, because the Spirit intercedes for the saints in accordance with God's will." 

Nevertheless, sometimes we get to a certain point where we are very weak 
because we fail in every effort. At this point, we can decline into hopelessness. 
However, for the saved believer, God will not forsake them. The Holy Spirit in our 
hearts will cry out and pray for us from our inner heart. 

Holy Spirit 29 

When we are weak and do not even want to pray, God knows. Why? It is 
because the Holy Spirit has prayed for us. "And he who searches our hearts knows the 

28 Romans 8:23. 

29 Romans 8:26-27. 


28 



mind of the Spirit." 30 "He who searches our heart" is the Lord who listens to prayer. In 


order for God to listen to prayer, we need to pray according to his will. When "the Spirit 
himself intercedes for us with groans that words cannot express," since the Spirit prays 
according to God's will, therefore God answers the prayer. 31 God's answers for Holy 
Spirit's prayers for us often surprises us. When we need patience, God gives us suffering 
since "suffering produce perseverance." 32 When we need obedience, God gives trial so 
that we " learn how to obedient from trial." 

God's Calling, Justification and Glorification 33 

For those who love God are "predestined to be conformed to the likeness of his 
Son." 34 They grow spiritually in the Father's plan," And those he predestined, he also 
called; those he called, he also justified; those he justified, he also glorified." 35 

God's plan for humans starts with "predestination" which includes foretelling 
and selection. The second step is "calling." Believers are called by God through the 
outwardly spreading of the gospel and inwardly touching by the Holy Spirit. The third 
step is "justification." For those who believe in Jesus as the Lord are justified by God. 


30 Romans 8:27. 

31 Romans 8:256. 

32 Romans 5:3. 

33 Romans 8:29-30. 

34 Romans 8:30. 

35 Romans 8:30. 


29 



This justification includes justification in position and in behavior. The final step is 
"glorification" which is be conformed to the likeness of his son and have the fragrance 
of Christ. We, believers are running toward our final glorious destination. 

The center of God's will and final destination of our life is "to be conformed to 
the likeness of his Son." This means that after we are saved and reborn, in our daily life, 
on one hand, with the Holy Spirit's inner help and work, on the other hand, through 
outside circumstance's molding, we are transformed gradually so that eventually we are 
conformed to the likeness of our Lord. 

The Bible teaches us to be delighted in the law of the Lord and meditate on it 
day and light. 36 Also, it teaches us to not be conformed any longer to the pattern of this 
world, but to be transformed by the renewing of your mind. 37 Therefore, the biblical 
solution for changing old self with new self is to replace worldly thinking with God's 
thought from the beginning to the end. 

Chapter 2 reviewed the theological framework of the Nature of Human and the 
Duty of Family, Marriage including a Man and a Woman, Relationship between Husband 
and Wife, Relationship between Parents and Children, God's punishment on Adam and 
Eve, and How to transform from Old Self to New Self. In Chapter 3, a comprehensive 
Literature Review on Chinese American will be presented. 


36 Psalm 1:2. 

37 Romans 12:2. 


30 



CHAPTER 3 


LITERATURE REVIEW 


Demographics of Chinese Americans 

According to the 2010 United States Census, the largest ethnic group among 
17.21 million Asian Americans was Chinese Americans (3.79 million, 21.9%), 1 which is 
one of the fastest growing ethnic groups in the United States at 5% per year. 2 
According to Ameridia, 

Chinese American is the largest Asian American group with a population of 
2,422,970 (Chinese only). It comprise 23.74% of the Asian American population 
and 0.86% of the US population. Its population growth rates is 47.5% from 1990 
to 2000. Nevertheless Chinese Americans' birth rates are lower than those of 
American whites, and as such their population is aging relatively quickly. 
Immigrant (native Chinese) population is 47% of Chinese American population. 

The leading States for Chinese Americans are California, New York, 
Hawaii, Texas and New Jersey. Together these five States constitute more then 
80% of the Chinese American population with 40% being in CA alone. Their 
median Household Income of $41,583 and the average Chinese household 
income is about 30% higher then the national average. About 84% of Chinese 
Americans between ages 35-44 own a home and the home ownership rate is 
65% compared to 54% for US average. 38% of Chinese Americans have Bachelors 
degree or higher compared to 22% for national average. 3 

In its report on "The Integration of Immigrants into the American Society," the 

National Academies of Science, Engineering and Medicine states. 

The process of integration depends upon the participation of immigrants and 
their descendants in major social institutions such as schools and the labor 


1 United States Census Bureau, "Asian Alone or in Combination with One or More Other Races, and with One or More 
Asian Categories for Selected Groups," posted 2011, accessed December 25, 2011. 

2 V.M. Ta, P. Hoick, and G.C. Gee, "Generational Status and Family Cohesion Effects on the Receipt of Mental Health 
Services Among Asian Americans: Findings from the National Latino and Asian American Study," American Journal of 
Public Health 100 (2010): 115-121. 

3 Ameridia, "Chinese American Demographics," posted 2016, accessed February 14, 2017, 
http://www.ameredia.com/resources/demographics/chinese.html. 

31 



market, as well as their social acceptance by other Americans. Greater 
integration implies movement toward parity of critical life opportunities with the 
native-born American majority. Integration may make immigrants and their 
children better off and in a better position to fully contribute to their 
communities, which is no doubt a major objective for the immigrants 
themselves. 4 

In terms of the health status of immigrants, the report states. 

Even though immigrants generally have better health than native-born 
Americans, they are disadvantaged when it comes to receiving health care to 
meet their preventive and medical health needs. The Affordable Care Act (ACA) 
seems likely to improve this situation for many poor immigrants, but 
undocumented immigrants are specifically excluded from all coverage under the 
ACA and are not entitled to any nonemergency care in U.S. hospitals. 5 


Current Health Service Usage and Literature 

Though the Chinese American population continues to rise in the U.S., the 
growing population's use of mental health services remains low, despite mental health 
issues that may develop upon settling into a new country. 6 According to Ta, Chinese 
Americans use less mental health care even though this ethnic group's population is 
growing. 7 Clinical studies and conceptual articles focusing on Chinese American families 
are few due to the low mental health utilization among Chinese Americans. In addition, 
Hsieh and Bean states, "With reduced information available regarding appropriate 


4 H. Yoshikawa, H., "The integration of immigrants into American society: a National Academy of Sciences Report," 
http://www.nap.edu/catalog/21746/the- integration-of-immigrants-into-american-society. 

5 Yoshikawa, Integration of Immigrants." 

6 Office of the Surgeon General (US), "Mental Health: Culture, Race, and Ethnicity," posted 2001 accessed March 19 
2017, https://www.ncbi.nlm.nih.gov/books/NBK44245/?report=reader#!po=0.793651. 

7 Ta, Hoick, and Gee, "Generational Status," 115-121. 


32 



treatments, clinicians are less able to effectively treat Chinese Americans which further 


deters members of this ethnic group from seeking out mental health assistance." 8 

Low mental health care utilization by the Chinese American community is likely 
due to several factors: language deficiency, poverty, lack of medical insurance, shame 
and losing face, and improper psychotherapy 9 . When Chinese first move to the US, their 
English language skills may be poor and they are unfamiliar with the custom and culture 
making it is hard to find a job, even entry level. Therefore, they may face prejudice and 
discrimination, which create vulnerability. 10 In addition, Chinese immigrants may not 
know how to or where to apply for social welfare and with little or no income, lack of 
medical insurance is also very common. The difficult economic conditions and cultural 
isolation can cause conflict, frustration, and suffering between family members in a 
Chinese American household. To make the situation worse, children are bicultural and 
different from their parents in many ways. 11 Indeed, Jung states. 


8 Alexander L. Hsieh and Roy A. Bean, "Understanding Familial Cultural Factors in Adolescent Depression: A 
Culturally-Competent Treatment for Working With Chinese American Families," The American Journal of Family 
Therapy 42 (2014): 399. 

9 Cheng, Z. H., "Asian Americans and European Americans' stigma levels in response to biological and social 
explanations of depression," Social Psychiatry and Psychiatric Epidemiology 50(5), 767-776. 

10 Nadal, K. L., Wong, Y., Sriken, J., Griffin, K., & Fujii-Doe, W. (2015). Racial microaggressions and Asian Americans: An 
exploratory study on within-group differences and mental health. Asian American Journal Of Psychology, 6(2), 136- 
144. Park, S. (2015). Depression and suicide ideation among Asian American youth: A twelve year longitudinal 
analysis. Dissertation Abstracts International Section A, 76. Cheng, H., Lin, S., & Cha, C. H. (2015). Perceived 
discrimination, intergenerational family conflicts, and depressive symptoms in foreign-born and U.S.-born Asian 
American emerging adults. Asian American Journal Of Psychology, 6(2), 107-116. Chu, J., Chi, K., Chen, K., & Leino, A. 
(2014). Ethnic variations in suicidal ideation and behaviors: A prominent subtype marked by nonpsychiatric factors 
among Asian Americans. Journal Of Clinical Psychology, 70(12), 1211- 1226. 


11 Iwamoto, D. K., & Liu, W. M., The impact of racial identity, ethnic identity, Asian values and race-related stress on 
Asian Americans and Asian international college students' psychological well-being. Journal of Counseling Psychology, 
57, 79-91 


33 



The multiple needs of many Chinese immigrants are well known and include 
such things as housing, income, employment, job training, English language 
skills, medical and child care, and transportation. Some immigrants arrive 
already depleted of resources and therefore are subject to crisis, loss of physical 
health, depression, and exploitation by unscrupulous employers; they may live 
in isolation, substandard housing conditions, or dangerous neighborhoods. Even 
worse, they are subject to the loss of respect and dignity. In short, there is no 
goodness of fit between many Chinese immigrant families and their adopted 
country, particularly those on the lower end of the social economic scale. 12 

Furthermore, if a Chinese American seeks clinical therapy, the therapist may not 
understand the cultural and social background of the patient. 


Variety within Chinese American Family 

The Chinese American population can be very diverse due to numerous 
variables, including place of origin in China, country from which they emigrated, 
circumstances of their immigration, time period of their immigration, generation and 
age, degree of assimilation, educational level, socioeconomic status, occupational skills, 
religious belief, and support system. 13 

Atwood and Conway state, "According to clinician, Lee, there are five types of 
Asian American families: (1) the traditional family, (2) the cultural conflict family, (3) the 
bicultural family, (4) the 'Americanized' family, and (5) the interracial family. These five 
types presented briefly below have been used to describe Chinese American families." 14 


12 Marshall Jung, Chinese American Family Therapy: A New Model for Clinicians, (International Phychotherapy 
Institute, 1998), 96. 

13 Jung, Chinese American Family Therapy, 67. 

14 Joan D. Atwood and Barbara Yee Mae Conway, "Therapy with Chinese American Families: A Social Constructionist 
Perspective," The American Journal of Family Therapy 32 (2004):156. 


34 



The traditional family usually consists of older single people or couples without 


children who usually immigrate to a "Chinatown" within cities in the United States. The 
traditional family tends to have limited exposure to "Western" culture and keeps 
traditional Chinese values, language, and dialects. 

The cultural conflict in a family involves of China-born parents and American- 
born children. They may experience family stress caused by differences in culture, 
language, gender, religion, and acculturation. The bicultural family consists of well- 
acculturated parents who grew up in major Chinese cities and were exposed to 
urbanization, industrialization, and Western culture influences before they arrived in the 
U.S. They are bilingual and bicultural, usually with high levels of education and high 
salaries. 

"Americanized" families consist of parents and children who are both born and 
raised in the United States. These families communicate in English only and tend not to 
maintain their ethnic identities. 

In the interracial family, some are able to integrate both cultures successfully. 
However, others may experience conflicts in values, religious beliefs, communication 
style, child-rearing issues, and in-law problems. 15 


15 Atwood and Conway, "Therapy with Chinese American Families,"156-157. 


35 



The Qualification and Competence of a Therapist 


Due to the various sub-groups that can make up the Chinese American Family, 
the qualification and competence of the therapist is vital for a successful therapy. From 
a strategic theorist's point of view, Soo-Floo emphasizes the importance of 
understanding the client's frame of reference which has such great importance when 
working with Chinese American families. 16 Fie states, "Many researchers have found 
that ethnic minority clients drop out of treatment after the first session at a rate of 50%. 
In contrast. White clients have a termination rate of less than 30%. It is possible that the 
failed therapy may be the result of therapist's inability or unwillingness to understand 
the client's frame of reference." 17 In other words, the therapist needs to be able to view 
the world as the client views it. 

Soo-Floo continues to explain what frame-of-reference is and its relationship to 
cognition. Fie states. 

Because realities for each member are cocreated, the realities can be changed 
by changing the perceptions and meanings members attached to them. 

Theorists at the MRI refer to the term 'client's position'. They define this as how 
the client perceives him- or herself, the problem situation and, ultimately, the 
meanings that a client attaches to those perceptions. Beck also discussed 
cognition and proposed that psychological problems are the result of clients 
distortions in thinking or illogical or inaccurate cognitions. The frame-of- 
reference concept presented here broadens the notion of cognition to include 
(a) someone's cultural context, (b) a sociopolitical economic context, and (c) an 
individual psychological context and how such a context may affect a person's 
perceptions about one or more problems. These three factors share many 
similarities to Floffman's concept of an "ecosystemic" approach to 
understanding psychological problems. She proposed that to work effectively 


16 Terry Soo-Hoo, "Brief Strategic Family Therapy with Chinese Americans," The American Journel of Family Therapy 
27 (1999) :166. 

17 Soo-Hoo, "Brief Strategic Family Therapy," 166. 


36 



with a person the therapist must have a complete understanding of that 
person's ecosystem. This includes someone's culture, sociopolitical conditions 
and psychology, as well as the community that he or she inhabits. 18 

When treating adolescent depression, especially in the cultural conflict family, 

Hsieh and Bean's points are helpful, since they 

examine key factors related to the culturally competent and therapeutically 
viable treatment for Chinese American adolescents struggling with depression 
(Sue, 2001). Specifically, treatment recommendations will be organized and 
presented here in terms of (a) therapist knowledge about the culture and 
worldview of the clients; (b) therapist awareness of their own culture, values, 
biases, and assumptions regarding the clients' ethnic cultural group; and (c) 
therapist skills- therapeutic strategies and interventions, relevant and 
appropriate for working with clients, given their culture and other contextual 
factors. In an effort to address aspects of both the Chinese American culture 
and the limitations imposed on the individual/family by depression, this 
approach follows Bean and Titus (2009), focusing on a "target that is 
simultaneously culturally and clinically relevant the intersection of the client's 
ethnic culture and the culture of the presenting problem." 19 

According to Hsieh and Bean, the therapist's knowledge about Chinese 
Americans which consists of academic achievement, cultural factors, saving face, 
collectivism, gender roles, family Hierarchy/Dynamics, Acculturation, Sexual 
Development and Dating. The therapist awareness consists of adolescent autonomy, 
degree of acculturation, role of academics. 20 

Jung's therapy is helpful for treating Chinese Americans since he emphasizes that 
the therapist not only needs to understand the client's problems brought to treatment, 
but also the "intrapersonal and family dynamics, stages of family development, and 


18 Soo-Hoo, "Brief Strategic Family Therapy," 166. 

19 Hsieh and Bean, "Understanding Familial Cultural Factors," 399. 

20 Hsieh and Bean, "Understanding Familial Cultural Factors," 399. 


37 



communication patterns," which are closely related to the cultural context of the 
families. 21 So, Jung examines the treatment of immigrant Chinese families from a 
Chinese, rather than the Asian or Western, perspective. 

Jung also states there are major differences among Chinese immigrated from 

Vietnam, China, Hong Kong, and Taiwan during different periods: 

These differences within the Chinese American population also influence the 
types of treatment issues that are brought to therapy. Some families bring with 
them concerns related to resettlement or cultural adjustment. Others have 
intergenerational issues, family violence, or marital conflict. Still others have 
severe psychopathology, including addictive behaviors. Interventions range 
from providing or assisting in the acquisition of education, training, services, and 
resources to providing individual, family. 22 

Additionally, Jung continues to lay out the major differences between Chinese 
and American cultures. The Chinese culture is heavily influenced by Confucianism, 
Taoism, and Buddhism. On the other hand, American culture is interwoven with Judeo- 
Christian religious beliefs and its political system and economic system. Understanding 
these differences may help the therapist to accomplish the treatment goal. In terms of 
patterns of relationship, the American vs. Chinese differences are equalitarianism vs. 
the hierarchical pattern, individual vs. family values, and individuality vs. lineage. In 
terms of cultural perspective, the American vs. Chinese differences are modern vs. 
traditional worldview, and materialistic vs. altruistic. In terms of self-perception, the 
American vs. Chinese differences are self-esteem vs. virtue, and guilt vs. shame. In terms 


21 Jung, "Chinese American Family Therapy," 50. 

22 Jung, "Chinese American Family Therapy," 68. 


38 



of types of expression, the American vs. Chinese difference is expression of feelings vs. 


control of feelings. 23 

Understanding the Chinese American client's culture, race, religion, birth place, 
family tradition, and generation difference is a must for a competent therapist to ensure 
a successful counseling outcome. 


Therapy Method Used 

For treating Chinese Americans, Soo-Hoo uses the Brief Strategic Therapy 
Method which consists of four principles, 

(a) human problems largely evolve from how one perceives one's situation 
(frame of reference), 

(b) problems occur because of mishandled difficult events, 

(c) continued application of solutions (attempted solutions) that are ineffective 
tend to make the problem worse, and 

(d) effective solutions rest on the application of new and different approaches 
that do not replicate the ineffective at tempted solutions and that should be 
in a different category (second- order change). 24 

Soo-Hoo also states. 

Brief strategic family therapy possesses many aspects that are consistent with 
Chinese American cultural characteristics. One major aspect is its ability to work 
within the family's cultural, sociopolitical, and psychological realities. For 
example, many Chinese Americans view psychological problems as problems in 
living or, more specifically, problems that require a specific way of behaving of 
which they do not have knowledge yet. The solution is try to find the proper 
way of behaving. This more effective way of behaving must fit certain cultural 
beliefs, patterns, and rules of social behavior. 25 


23 Jung, Chinese American Family Therapy, 74-78. 

24 Soo-Hoo, "Brief Strategic Family Therapy," 165. 

25 Soo-Hoo, "Brief Strategic Family Therapy," 171. 


39 



According to Soo-Hoo, strategic family therapy has many aspects which are 


especially suited to working with Chinese Americans: session time is limited, and it 
focuses on solving a specific problem, it focuses more on changing interactions between 
members, it focuses on the present and the near future, it focuses on changing 
perceptions and ineffective behaviors, it works within the client's frame of reference, 
and it focuses on developing behaviorally based new solutions. 26 

In geneal, I agree with the process of brief strategic method, which is similar to 
the treatment process I propose in chapter 4. But, I add attachment as the spine of my 
treatment and biblical thought as the motivation for the client to drive the new 
strategy. 

For treating adolescent Chinese Americans with depression, Hsieh and Bean 


state. 


Cognitive behavioral therapy (CBT) resonates with Chinese American clinical 
populations and has been demonstrated to be an effective treatment. In 
addition, the CBT model has also shown efficacy in adolescent depression. 
Although, research on the effectiveness of CBT with the Chinese American 
population is lacking, there are several key conceptual reasons for the argued 
appropriateness of this therapy approach. 27 

The first advantage of CBT is its confrontation with the presenting problem of 
the depressed individual directly and equipping the adolescent with better coping 
strategies in the early stage of treatment. The rest of the family can be exempt, allowing 
them to save face and avoid pressure. Second, since the unrealistic expectations of 


26 Soo-Hoo, "Brief Strategic Family Therapy," 174. 

27 Hsieh and Bean, "Understanding Familial Cultural Factors," 408-409. 


40 



academic achievement and behavior change are placed upon the adolescent by 
themselves, most adolescent depression is internalized and the negative cognitive 
schemes are developed. This problem can be addressed by CBT by utilizing the cognitive 
restructuring methodology. In addition, the positive thought training, time 
management, and goal setting exercises can be used to combat negative schemes. Last, 
during the final stages of CBT treatment, the therapist would help the adolescent to gain 
social and family support to help him or her to maintain the changes that they have 
made. At the same time, the adolescent's positive change can foster change within the 
family. 28 

Even though Atwood and Conway's final choice of a therapy treatment method 
for Chinese American population is a solution-focused therapy from a social 
constructionist perspective, they compare modernist perspective from the early time to 
post-modernist perspective of their choice. 29 
They state. 

Historically, to understand an individual's or a family's psychological problems, 
the focus was mainly on peoples' experiences, their unique histories or specific 
early child development. They gathered information as a basis for planning 
interventions, for identifying deficits, weaknesses, or wounds. Therapy in this 
view attempted to change, remediate, or heal. 

As the field of psychotherapy evolved to a problem-focused (behavioral 
or systemic) or a problem solving perspective, behavior was explained within a 
causal or functional system. The second approach, represented by the structural 
family therapists, focused now on regulating internal and external boundaries 
and intergenerational ties, supporting the parent's position in hierarchy, and to 
structurally couple spouses and parent-child subsystems within the family while 


28 Y.-N. Lin, "The Application of Cognitive-Behavioral Therapy to Counseling Chinese," American Journal of 
Psychotherapy 56 (2002): 46-58. 

29 Atwood and Conway, "Therapy with Chinese American Families," 157. 


41 



holding onto the notion that there was a template for "norm" family 
functioning. 30 

The modernist therapy approach focuses on the family deficits and/or how far 

this family was from the norm. Atwood and Conway continue on the third approach. 

The solution focused therapists represent the third approach. While adhering to 
post-modernist assumptions, these theorists address and focus on the 
competencies and strengths of the clients, thereby replacing the focus on 
dysfunction with a focus on success. The goals of this brief therapy include 
helping clients change some of the intentions or interpretations to new 
resolutions that can be found to problems with the family's complaint. 31 

According to Atwood and Conway, the therapy based on modernist or deficit 

assumptions, emphasizes that the therapist is the expert who has absolute knowledge. 

Problems in the family were caused by dysfunctional families or poor problem-solving 

strategies. After the therapeutic intervention, positive change occurs as a result. "This 

view assumes there is a singular truth and if we dig deeply enough we can discover it." 32 

Doherty argued that these prevailing theories of family therapy reflect their 
biases and underlying assumptions regarding what constitutes truth or reality 
and fails to deal with issues such as gender, ethnicity, and the impact of the 
larger social system, such as political and economic forces. According to Wu, 
Enders, and Ham, the notion of this perspective does not take into account the 
diversity of cultural experiences, and instead forces the experiences of Chinese 
American families into limited and often stereotyped categories. 

Therefore in response to the deficit model to problems based on modernist 
assumptions, Atwood and Conway adopt the solution-focused therapy, "rather than 


30 Atwood and Conway, "Therapy with Chinese American Families," 157. 

31 Atwood and Conway, "Therapy with Chinese American Families," 158. 

32 Atwood and Conway, "Therapy with Chinese American Families," 159. 


42 



focusing on problems and deficits, it encourages the competencies, resources, and 
strengths of clients, thereby replacing the deficit assumption with one of success." 33 

Solution-focused family therapy is built on the philosophy of social 
constructionism. 34 "The solution-focused therapist assumes that the family already 
knows what they need to do to solve their problems. Therefore, the therapist's task was 
to help the person or the family to construct a new use for knowledge they already 
have." 35 Clients, not the therapists, are the experts on their problems. 36 Atwood and 
Conway also state, "Many Asian Americans have recently challenged this traditional 
view. They are increasingly challenging the concepts of normality and abnormality in 
that they believe that their values and lifestyles are often seen by American society as 
pathological and thus are unfairly discriminated against by clinicians." 37 

In terms of a social constructionist's view, according to Atwood and Conway, the 
family is not seen as being the problem, but how the family uses language to talk about 
a family situation. 38 For clinicians using a social constructionist perspective in working 
with a family, there is the recognition of the diverse meanings that families attach to 


33 Jung, Chinese American Family Therapy, 161. 

34 S.T. Gladding, Family, Theory, and Practice, 3 rd ed. (Upper Saddle River, NJ: Pearson Education, 2002). 

35 1. Goldenberg and H. Goldenberg, Family Therapy: An Overview, 5 th ed. (Belmont, CA: Wadsworth/Thomson 
Learning, 2000). 

36 Jung, Chinese American Family Therapy, 162. 

37 D.W. Sue and D. Sue, "Counseling Asian Americans," in D.W.Sue & D.Sue, Counseling the Culturally Different: Theory 
and Practice, 3 rd ed. (New York, NY: John Wiley & Sons, 1999). 

38 S-J Wu, L.E. Enders, and M.A.D-C. Hams, "Social Construction Inquiry in Family Therapy with Chinese Americans," 
Journal of Family Social Work 2(2) (1997): 111-128. 


43 



their experiences and an emphasis on identifying resources and strengths. The premise 


is that there are many meanings that can be given to a situation, and the therapist's 
interpretation of a family's story is not necessarily the "correct" account. The role of the 
clinician, adopting a "not-knowing" position, is to create a context encouraging the 
exploration of a problem through conversation and dialogue about the client's reality 
and evolving life story. 39 During treatment, when members of a family reexamine their 
life stories, new meaning is co-constructed in conversation, and new options and 
solutions may arise with the help from the therapist to empower family members to 
change. 40 For treating Chinese Americans, we may need to focus on past/current 
problems and also the future hope. 

I adopt the concepts of solution-focused therapy on dysfunctional families, poor 
problem-solving strategies and emphasizing on end outcomes to my treatment method 
mentioned in chapter 4. But, I disagree with its view that the client is the expert of his or 
her problem. I view the therapist as a coach to guide the client to a successful end 
outcome. 

The Chinese American Family Therapy (CAFT) that Jung uses is a comprehensive 
family therapy model based on family integration theory, general systems theory, and 
case management, combined with crisis intervention and social learning theory. 41 In 


39 Wu, Enders, and Hams, "Social Construction Inquiry," 111-128. 

40 S. Friedman, ed.. The New Language of Change: Constructive Collaboration in Psychotherapy, (New York, NY: 
Guilford Press, 1993). 

41 Jung, Chinese American Family Therapy, 88. 


44 



addition, other models such as Structural Family Therapy, Strategic Therapy, Planned 


Short-Term Treatment, Rational Emotive Therapy, Solution Focused Therapy, and 
Contextual Family Therapy could be used in conjunction with CAFT as needed since the 
Chinese American families are diverse. 

Jung states. 

The CAFT model uses the concept of family integration as the cornerstone of its 
conceptual framework and underpins it with ethical principles founded on 
Confucian humanitarianism. Family integration is defined as the state of being in 
a harmonious relationship with one's family by learning to live ethically with 
family members. For Chinese Americans to live a harmonious life, they must 
relate to their family within the context of Chinese American culture. The task of 
individual family members, therefore, is to understand their cultural context 
and then live accordingly. In many instances, however, problems arise because 
of the inability of family members to negotiate or assimilate cultural differences. 
CAFT's goal is to help such families resolve those as well as other problems that 
prevent family integration and to help family members to live ethically in 
harmonious relationship to one another. This is accomplished by using clinical 
interventions and techniques based on the theories and models incorporated in 
CAFT, CAFT's own principles of practice, and other models that can be used in 
conjunction with it. 42 

Jung's therapy method, using the six models presented above may be the most 

relevant method to treat Chinese American which 

allows therapists to be more creative and to have a broader range of 
interventions from which to choose. It also allows us to adapt to the 
expectations of clients and the style in which they work best. Although the major 
objective of treatment is to assist clients in achieving family integration by 
resolving the issues they bring to treatment, it may be better to focus on 
solutions with some families, to work with others strategically, and to work with 
still others cognitively. Thus, we can use the model that best suits our clients' 
needs. 43 


42 Jung, Chinese American Family Therapy, 89. 

43 Jung, Chinese American Family Therapy, 133. 


45 



Even though Emotion-focused Therapy is not used by therapists that I have 


surveyed, in the report of "Mental Health: Culture, Race, and Ethnicity from Surgeon 
General (US)," it states. 

Culture shapes the expression and recognition of psychiatric problems. Western 
culture makes a distinction between the mind and body, but many Asian cultures 
do not (Lin, 1996). Therefore, it has long been hypothesized that Asians express 
more somatic symptoms of distress than white Americans. The influence of the 
teachings and philosophies of a Confucian, collectivist tradition discourages open 
displays of emotions, in order to maintain social and familial harmony or to avoid 
exposure of personal weakness. 

The report goes on to state. 

It has been found that Chinese Americans are more likely to exhibit somatic 
complaints of depression than are African Americans or whites (Chang, 1985), 
and Chinese Americans with mood disorders exhibit more somatic symptoms 
than do white Americans (Hsu & Folstein, 1997). Mental health professionals 
who rely solely on the standard psychiatric diagnoses used in the United States 
may not identify these somatic expressions of distress. 

Therefore, I adopt EFT as one of the therapies in my integrated treatment method 

mentioned in chapter 1. 

Chapter 3 reviewed demographics of Chinese Americans, current health usage, 
variety within the Chinese American family, the qualification and competence of the 
therapist, and the literature consisting counseling method using for treating Chinese 
Americans. In chapter 4, the project design of my treatment method will be presented. 


46 



CHAPTER 4 


PROJECT DESIGN 


A Chinese American Couple and Their MBTI 1 Results 

C and T are a Chinese American couple who currently live in New Jersey. They 
have moved between the U.S. and China several times. T is a lawyer in New York City 
who received his law degree at the University of Pennsylvania. C is a housewife who 
cares for their two little girls. Near the end of 2015, they came to me because of 
constant marital conflict between them and because C could no longer bear to have T 1 
parents living with them. In addition, they faced a major decision of whether to move 
back to New Jersey or to stay in China. 

The instrument of Myers-Briggs Type Indicator (MBTI) was used to understand 
my clients' personality. MBTI identifies 16 distinctive personality types, but it sorts for 
preferences and does not measure trait, ability, or character. 

T’s MBTI Results 

ESTJ: The Supervisor - Extroverted, Sensing, Thinking, and Judging 

• Realistic, Outgoing, Systematic, Dependable 

• Dignified, strong-willed and principled 


1 The Myers & Briggs Foundation, Myers-Briggs Type Indicator, posted 2017, accessed March 19, 
http://www.myersbriggs.org/my-mbti-personality-type/mbti-basics/ 



Extremely loyal to family, community and country 


• Great strategist and outstanding "game" player 

• Respect tradition and order 

• Highly ethical, hardworking, dedicated, and honest 

• Lives in the observable "real world" and focused on what is practical 

• Extremely organized with difficulty dealing with uncertainties 

• Responsible and would rather plan before acting 


Summary 

T beleived the MBTI results matched his own understanding of himself. Because 
he is strong-willed and highly organized, he constantly and consistently commented on 
C's unorganized behavior, resulting in C's bad feelings and reactions. Also, because he is 
extremely loyal to and respects his parents, he wishes to try his best to satisfy his 
parents' wishes, also resulting in C feeling it was a sacrifice for T's parents to live with 
them for such a long period of time. 


C's MBTI Results 

ESFJ: The Provider; Extroverted, Sensing, Feeling, and Judging 

• True extrovert and social butterfly 

• Sensitive, energetic, helpful and sociable 


48 



Popular and well-liked among family, friends and communities 


• Compassionate and empathetic 

• Life of the party 

• Always ready to listen with warmth and genuine sensitivity 

• Love being seen as role model 

• Extremely organized with difficulty dealing with uncertainties 

• Prefer to live in the real world rather in your own imagination 


Summary 

C believes some of her personality has changed during the course of her life. She 
thought she was an extroverted, compassionate, and empathetic social butterfly when 
she was a child, but due to the unfriendly attitude toward her from her senior relatives, 
she had to behave and restrain herself. While living in Beijing, the environment was 
more friendly and required her to handle things by herself; so, her natural personality 
was revealed. In addition, C's mother gave her a lot of freedom during her childhood, 
and as a result, C was used to an unorganized free living style. However, T is very 
organized, and after so many years of marriage, C has adjusted to T's orderly life style. 
Last, C is emotional and T is rational. Their interaction pattern is affected by this 
personality difference greatly. 


49 



Family History 


T was born in 1977 as the second son. C was born in 1976 as the only child in the 
family. They were married in 2004, and their daughters were born in 2010 and 2012. 

T has a very good relationship with his brother, who is seven years older than he. 
T's brother had lived with his grandma until he was seven years old. After his brother 
went to college, T was the only son at home, receiving all of his parents' love and 
attention. T's parents are both strong-willed and pay attention to detail. His father is 
introverted and slow to act, but his mother is extroverted and quick to respond. As they 
have aged, they argue more and dig in more on their respective opinions. 

Both of T's parents were born in 1939. T's father belonged to the labor class, 
which was acceptable according to the communist standard. He majored in Structural 
Engineering in Shanghai first, but changed to Mathematics in Shian. He complained 
about this change after the economic boom in China because many of his Structural 
Engineering classmates had become rich. T's mother's relative was in Kuomintang, 
which was unacceptable for her family according to the communist standard. T's 
parents were married in 1968, following the Cultural Revelation that began in 1966. Due 
to T's mother's unacceptable class, she was prosecuted during the Cultural Revelation. 

T's father's parents were born in 1911 (grandfather) and 1910 (grandmother). 

His grandfather was a railway worker and his grandmother was a housewife. T's father 
has three older brothers and two older sisters, born in 1931,1933,1936,1946 and 
1949. His three brothers died in 2002, 2006, and 2016. T's father's relationship with his 
parents and brother/sister were good, but he left Shanghai to go to college in Xi'an. As a 


50 


result, he did not see his parents very often. T's mother's parents were born in 1907 
(grandfather) and 1914(grandmother). Grandfather was a governmental official and 
grandmother was a housewife. T's mother has one older brother, three younger 
brothers and one younger sister and they were born in 1934,1945,1947,1950 and 

1942. T's mother's relationship with her parents, brother, and sister were very good. 

Being university professors, both of T's parents cared deeply about T's academic 
accomplishments. T rebelled as a teenager, but when he entered the university, he 
appreciated more of his parents' loving care, and he began to treat his parents nicely. 
Due to his parents' high standards of education, T was not over-indulged, and he tried to 
do his best to perform well in order to earn his parents' and others' praise. After he 
became a Christian, he relaxed on enforcing these high standards on himself. 

In 1984, T left home to go to college in the U.S. to study chemistry. In 2004, he 
changed his major to Law. In the same year, T married C. During the first 3 years, their 
finances were very tight, and when it was time to pay the tuition, he had a hard time to 
pay it because he did not have enough money. Finances were so tight that, on one 
occasion, C did not have enough money to see a doctor, not having medical insurance. 

In 2007, T graduated and joined a law firm. He first went to China to work with C, then 
in 2009, he returned to the U.S. In 2013, he worked in a Beijing office until July 2016. 

C's grandfather was a businessman and landlord who used to own a large old- 
style house where both sons' families lived together. C's father had one older brother, 
one younger brother, two older sisters and one younger sister and they were born in 

1943, 1953, 1938, 1941 and 1948. C's father was born in 1945. Because C's grandfather's 


51 


brother was a Kuomintang officer, their whole family's social class was unacceptable. 


Therefore, two of C's aunts could not go to school. Plus, one of the boys had to join the 
army. C's father took this duty, and he joined the army at the age of 15. Unfortunately, 
due to his unacceptable social class, he could not be promoted to a high-ranking officer, 
and he retired early. Later in his life, he worked in a factory as a general manager. He 
was an extravert, but he had low self-esteem, treasured money heavily, and being self- 
centered, felt little for others. While C's father did not have a close relationship with his 
parents or his brother, he does have close relationship with his sisters. 

C's mother was born in 1947 and she has three older brothers and they were 
born in 1929,1931 and 1938. She could not get into a college due to her unacceptable 
social class, having a relative in Taiwan. Therefore, she became a truck driver, and 
although her life was tough, she is a gentle and generous woman who has an 
unconditional love for her husband. C's parents married in 1975. Before the economic 
booms around 2000, most of the people lived in traditional courtyards, chatting and 
eating together. Nevertheless, after the economic booms, high-rise apartments replaced 
traditional courtyards, adults were busy making money, communication between 
families decreased, and many kids were home alone. 

Grandmother loved her first son better than C's father. So C also did not receive 
quality care and attention from her grandparents. C learned to please others and felt 
alone during her youth. She had a much better relation with her mother, but her mother 
was strict regarding her behavior and education. Even though C was the only child at 
home, she did not develop the "little emperor syndrome." She was rebellious during 


52 


middle school, and she let her studies slide. Therefore, she did not enter into a better 


high school. However, C began to study hard in high school and university. Becasue C 
grew up in a large family with many relatives who often criticized her parents and her, 
she was sensitive to others' opinions and learned to please others. She believed in Jesus 
during college years, and became very displeased with lying and intentionally seeking to 
please others. 

C and T began to date at the college Bible study group. After T went to the U.S., 

C felt insecure about their long-distance relationship. When C first met T's parents, T's 
father was emotionless toward her. In 2004, when C and T wanted to marry, T's parents 
were against this idea and wanted them to marry after T graduated from law school. 
However, they married anyway, and T started his law school program. Even though C 
and T experienced financial difficulty, they learned to face hardship together. Due to T's 
acceptance and assurance toward C, their marriage became stronger gradually. 

Intrafamily Transactions and Relationships 

The three most troubling problems that C had with T were: 

1. As the beloved son, T is very obedient to and caring for his parents. 

Whenever his parents want to live with them, C has expressed her wish that 
they live with them up to 3 months. However, T always tried to convince C 
that they could stay whenever they wanted and for how long they wanted. 
Because T is strong-willed, C was angry at first, but then she was okay with 
his decision, being more understanding of his parents' feelings. Even though 


53 


C is still unhappy with T's parents living with them once every year for about 


half a year, she has a better relationship with his parents, and is more 
accepting of this situation. 

2. When C teaches or cares for their daughters, T sometimes offers gentle 
suggestions, angering C. She feels that T does not trust her and she reacts 
harshly. She is not sure why she reacts that way, but she cannot stand T's 
demanding attitude. 

3. After they returned to Beijing in 2013, C wanted to have consistent quality 
time with T, to which T agreed. Unfortunately, they could not find a good 
time or a good place to go. Even when they are together, T is not very 
enthusiastic, and C does not feel they have quality time together. 

What C did that T could not stand: 

1. When they argue, C reacts emotionally, crying or throwing things. After some 
time passes, C becomes more calm. 

2. T asks for sex and is not being fulfilled. 

3. When T talks to his parents, C listens carefully and complaints. 

The three most troubling problems that T had with C were: 

1. When T says something small, C is sensitive and reacts with emotion that T 
believes is unnecessary. 


54 


2. When they argue, C reacts emotionally, crying or throwing things. T got really 
mad when C threw his cell phone at him. Sometimes, T argues back; other 
times, T remains quiet for a while. Most of the time, T makes peace with C 
after a while. 

3. When T talks to his mother on the phone, C listens carefully and tells T what 
to say and what not to say, which annoys T. As a means to work around this, 

T finds time at work to call his Mom. 

4. When some things happen, C worries too much and assumes bad things will 
happen. 

5. T asks for sex and is not being fulfilled. Sometimes, they make an agreement 
in advance during the day. T anticipates making love, but C is busy and time 
goes by. When it is late, C has lost energy for sex and refuses T, who 
becomes disappointed. 

Major Steps of Treatment Process 

Because the theoretical methodology of therapy is an integrated Attachment- 
centered, Emotionally Focused, Cognitive Family Therapy, the treatment plan is 
designed to combine these methods. The first three steps focus on attachment 
centered, exploring outer behavior, inner feelings, and thinking. The fourth step allows 
both spouses to understand their old interaction patterns. The fifth step is Emotionally 
Focused to heal any old wounds in order to erase any negative feeling. Steps six 
through eight are Cognitive-Behavioral, changing the perceptions of root problem 


55 


events based on biblical teaching to initiate new attachment feelings that produce new 
attachment behavior. Finally, the new interaction pattern will be formed. 

The steps are: 

1. Express current attachment problem/behavior. 

2. Express current attachment feeling. 

3. Express current attachment thinking. 

4. Discuss the old interaction pattern. 

5. Heal old attachment wound. 

6. Build new attachment thinking. 

7. Express new attachment feeling. 

8. Build new attachment behavior. 

9. Build new interaction pattern. 

Treatment Plan 

With the final outcome of the therapy in mind, the whole process of the therapy 
is to equip the couple to be able to express their outer and inner feelings freely, to 
understand their attachment style and reaction/interaction patterns, to heal old 
wounds, to seek forgiveness on old attacks, to change old perceptions with God's 
wisdom, and to replace old reaction patterns with new godly reaction patterns. 

Description of the actual conduct of the therapy and the progress made 
following the treatment plan follows. Each counseling session occurred once every week 
for one to two hours. The number of total sessions is set to be no more than ten. 


56 



Each session follows the major steps of treatment process. 


Session 1: 

1. Collect the three most troubling problems from the husband and wife. 
Encourage the clients to describe the events and express their outer and 
inner feelings. 

2. Observe the couple's reaction/interaction patterns. 

3. Homework: Identify 2 or 3 things you can do to improve your current 
relationships. 

Session 2 

1. Review homework. 

2. Share self attachment style from their own understanding. 

3. Homework: practice ABC communication. 

The ABC communication model is a modified version of XYZ statement 2 which 
involves 3 steps: 

• Step A: Person 1 initiating the conversation with a complaint, telling person 2 
what happened and what person 2 did or said, and expresses his/her own 
feelings without criticizing person 2. 


2 Stanley, S.M., Trathen, D., & Bryan, M., A Lasting Promise: A Christian Guide to Fighting for Your Marriage. San 
Francisco, CA: Jossey Bass, 1998. 


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Step B: Person 2 listens and repeats what person 1 said without adding or 


subtracting anything, or without trying to explain in his/her own words. 

• Step C: Person 1 tells person 2 whether he/she repeated it correctly or not. 
When person 1 is offended by person 2, ABC communication provides person 1 a 
healthy and safe platform to release his/her bad feelings. It also makes it 
possible for person 2 to understand person l's hurt feeling in response to person 
2's action or statememt. After step C, if person 2 is willing to apologize to person 
1, it can end with an effective resolution to the problem. 


Session 3 

1. Review homework. 

2. Explore self attachment style and find out the family root. 

3. Homework: 1) Take MBTI, 2) Draw Genograms. 


Session 4 

1. Review homework. 

2. Explore root problems in the interaction patterns of their marriage. 

3. Homework: examine self on own root problems of their marriage. 


Session 5 

1. Review homework. 

2. Explore MBTI results. 


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3. Based on spouse's MBTI results, share thinking and feeling with the spouse. 

4. Homework: based on new understanding of spouse's MBTI results, see 
whether it changes own reaction pattern. 

Session 6 

1. Review homework. 

2. For each root problem, find relevant Bible verses to see how they speak to 
the root problems. 

3. Homework: talk to each other about the root problems and seek forgiveness. 

Session 7 

1. Review homework. 

2. Share how relevant Bible verses help to solve each root problem. 

3. Homework: think about what is old self and how old self could die. 

Session 8 

1. Review homework. 

2. There are two things needed to do in order to let the old self die: 1) forgive 
persons who hurt me in the past, 2) seek forgiveness from persons whom I 
hurt in the past. 

3. Homework: meditate on Romans 8 and see how the new self could live. 


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Session 9 


1. Review homework. 

2. For each root problem, see how relevant Bible verses help to build new 
reaction patterns. 

3. Homework: from new thinking to see what the new feeling is and behave 
accordingly. 


Session 10 

1. Review homework. 

2. Discuss final wrap-up of sessions. 

3. Homework: let God's words in the heart guide everyday life. 

Chapter 4 reviewed the young Chinese American couple's brief description, their 
MBTI Results, family history, intrafamily relationship and transactions, major steps of 
treatment process, and treatment plan. In chapter 5, the treatment outcome will be 
presented. 


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CHAPTER 5 


OUTCOMES 


Application of Therapy 

This chapter describes the progress of a young Chinese American couple who 
received therapy based on the pre-designed treatment plan outlined in the previous 
chapter. The counseling sessions occurred in ten sessions that occurred once every two 
weeks for one to two hours. 

C and T sought therapy due to conflicts in their marriage. They have moved back 
and forth between the United States and China several times. T, the husband, is a 38- 
year-old lawyer who received his law degree at the University of Pennsylvania and 
practiced law in New York City. C, the wife, is a 39-year-old housewife who takes care of 
their two little girls. The major conflict the couple dealt with was C's dissatisfaction with 
T's parents living with them. When the couple first came to see me at the end of 2015, 
they also faced a major decision of whether to remain in New Jersey or return to China. 

Session 1 

After an initial discussion, the couple decided to move forward with formal 
counseling to help resolve their conflicts. The first session began early in 2016. The 
session 1 objectives were to collect the three most troubling problems between the 
husband and wife, to encourage the clients to describe the events and express their 
outer and inner feelings, and to observe the couple's reaction/interaction patterns. 


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The three most troubling problems for each spouse was described in detail in the 


Intrafamily Transactions and Relationship section of chapter 4. For C, the first most 
troubling problem was related to T's parents' demand, the second was related to how to 
raise their daughters, and the third was related to themselves. For T, the the first most 
troubling problem was related to C's emotional reactions, the second was related to 
their sexual life, and the third was related to T's mother. 

During session 1, I made three observations from their interactions: 

1. When C talked, T usually kept quiet. But when T talked, C frequently interrupted 
T with corrections. 

2. T made frequent judgmental comments of C. For example, when C would be on 
the toilet with a cell phone in hand, if C still had not finished toileting after a 
while, T would say to her, "You are watching Wechat conversation and you are 
not toileting" with a critical tone of voice. 

3. When C needed more attention and care from T, T believed he did more than 
other husbands and refused to do more. This interaction seemed to be a typical 
pursuer/distancer attachment 1 . 

The couple's Session 1 homework was to do 2 or 3 things to satisfy their spouse's 
needs and to improve their relationships. The purpose of the homework was to allow 
them to try to do whatever they thought would help to improve their problems, so that 
the therapist would know how willing the clients were to resolve their conflicts. 


1 The Gottman Institute, "How to Avoid the Pursuer-Distancer Pattern in Your Relationship," posted 2017, accessed 
March 19, 2017, https://www.gottman.com/blog/how-to-avoid-the-pursuer-distancer-pattern-in-your-relationship/. 

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Session 2 


The treatment plan objectives for the second session included a review of the 
couple's Session 1 homework and time devoted to the couple sharing their self¬ 
attachment style from their own understanding. 

During the Session 1 homework review, T indicated he did the following to 
improve their relationship: 

1) Tried to provide C with more quality time and tried to improve their mutual 
communication. 

2) Paid more attention to not comment or criticize C. 

3) Gave C more little gifts. 

4) Took care of C more and did more things for C. 

C worked on the following to improve their relationship: 

1) Satisfied T with more of his sexual needs. 

2) Gave T more little gifts. 

3) Took care of T more and did more things for T. 

The results of their homework demonstrated they were willing to address one 
another's needs. Even though they had not touched on the issue of T's parents, T 
did his best. 

Following the review, we discussed their attachment patterns from their own 
understanding as follows: When T began to comment or criticize C in pride, C explained 
her reason, T argued back and disagreed, C cried or threw things, and T kept quiet. 

Often, by the end, T expressed his regret and aplogized to C. 


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At the end of the session, I assigned homework that encouraged the couple to 


practice ABC communication at every opportunity. This was assigned because the 
couple's attachment pattern showed that they lacked the communication skills to share 
their inner thoughts in a healthy way, resulting in frequent conversations escalating to 
arguments. The details of the ABC communication model was described in chapter 4. 

Session 3 

The objectives of the third session included a review of the previous session's 
homework, and explored the couple's self-attachment styles and family roots. 

We first reviewed the homework from session 2. During the Chinese new year 
vacation, the couple practiced ABC communication to discuss the arguments that 
occurred during a trip to their parents' homes. They discovered through this method 
that they could more effectively communicate their feelings and thoughts with one 
another. 

T and C's self-attachment styles with their parents and significant others are 
described in detail in the Family History section of chapter 4. T's parents maintained 
traditional Chinese family values, such as parents had absolute authority over their 
children, but they were less affected by the Cultural Revelation. On the other hand, C 
lacked the love from her father and grandparents and it reflected upon her insecure 
attachment to T. 

As homework, T and C had to take an MBTI instrument in order to compare the 
instrument results to their own understanding of themselves and one another. Based on 


64 



the family history collected, I drew genogram, a graphic representation of a family tree 


that displays detailed data on relationships among individuals to reveal any pattern in 
their large family tree. I asked the couple to draw genogram based on my example for 
the next session. 


Session 4 

The objectives for the fourth session was to review the previous session's 
homework and to explore root problems of their marriage. When the review of their 
homework from the previous session was to occur, the couple informed me they had 
completed the MBTI, but forgot to save the full results. We determined they would 
retake the MBTI for discussion in the next session. The genogram did not show any 
mental illness or severe physical illness in either T or C's family branches. Since the 
genogram does not add any information to the understanding of the family, it is not 
included in the thesis as an appendix. Nevertheless, it did show several closed and 
distant interactional patterns which affected T and C's personalities. 

From my observations, the root problems of their current interactions are as 
follows: 

T 

□ His close relationship with his mother. 

□ His requirement of perfection on C. 

C 

□ C had low self-esteem towards T's parents due to... 


65 


o C did not work after she married. Without her own salary, C felt insecure 


when she spent money. 

o While C was in college, her father was prosecuted because his 

subordinate's check was returned without enough cash in the account. 
Her father had to borrow money from relatives and friends to pay the 
bank. T paid a large sum to C's father after he began to work. C and T had 
not told T's parents about this yet. 

At the end of the session, I asked them to redo MBTI as their homework. 

Session 5 

The objectives for the fifth session included a homework review of their MBTI 
results, allowing time for them to share their thoughts and feelings based on their MBTI 
results. Their homework following this session was to determine if they changed own 
reaction patterns, having a new understanding of each other's MBTI result. 

Based on the family history and their MBTI results, the influences on root 
problems of their interactions were two-folds: their parents and their personalities. 

T's parents were very organized and lived an orderly life style and T was like 
them. When T's parents lived with them, they forced C to follow their life style and 
habits. T's parents also did not respect C's boundaries; for example, they would open 
C's door without knocking and examined C's closet without asking. When T's father was 
upset, he would lecture C right away. When T's mother was upset, she would show her 


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negative feeling on her face. When these things happened, C would feel bad, but kept 


quiet and hid her feelings. 

C's influence from her parents came mostly from her mother. When C was 
young, her mother provided good care for her. So, C was used to relying on her mother. 
C is a mother now. She has a tendency to have her mother around to help her to take 
care of her daily duties. 

As for their personalities, because C was emotional and T was rational most of 
the time, when C wanted to talk to T to express her emotions, T always tried to solve 
her problems with reasoning. When C complained about T's parents, T was impatient 
and did not want to listen. 

The ways C and T handled conflicts in their marriage was not healthy. First, 
when C was not satisfied with T, C used sex to control T or punish T. Second, T was used 
to lecturing C and did not attempt to understand her thoughts or feelings. 

Before the end of this session, after sharing and discussing the above, C and T 
confessed their wrongdoing to God and asked for his forgiveness. 

At the end of the session, I gave them the homework as follows: 

1. Confess their wrongdoing to each other and ask for forgiveness. 

2. Seek Bible verses to change their perception on how to live with T's parents. I 
suggested they begin with Genesis 2:18-24; Ephesians 5:22-33; and Romans 15:1-6 

3. C learned how to live independent from her mother, mentally and physically. 


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Session 6 


According to the treatment plan, during the sixth session, the objectives included 
a review of the previous session's homework and each one's root problems, finding 
relevant Bible verses to see how they spoke to their situations. 

The results of the homework review included: 

1. They had sincerely confessed their wrongdoing to one another, asked for 
forgiveness, and were willing to change their wrongdoing in the future. 

2. As for seeking Bible verses on changing their perception on how to live with 
T's parents, C did the following: C used to feel that T and T's parents were 
strong-willed, forcing her to comply with what they wanted. After T and C 
could communicate calmly, T expressed his vulnerability and apologized to C. 
C began to understand T's feelings toward his parents and began to do the 
inconvenient things for his sake. When C saw T had a happy time with his 
parents, she felt happy too; therefore, she transformed her forced sacrificial 
feeling to authentic happiness. 

Although T felt he was independent from his parents, he could understand his 
parents' expectations for him. He wanted to honor his parents, but he also realized he 
needed to consider C's feelings. He wanted to keep a balance between his parents and 
wife. He determined to attempt to have consensus with C on everything. T used to 
criticize C often. Now he communicated and understood C with a more accepting 
attitude. 


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As for C to learn how to be independent from her mother mentally and 


physically, C shared the following: C's mother had taken good care of her from 
childhood, so C was used to it. Even when C was the mother of two, C depended on her 
mother to take care of the household when her mother stayed with her. Plus, her 
mother liked to do things for C's family. This was not a major problem for C and T's 
relationship. C determined to consider how she might reduce her dependency on her 
mother. 

We concluded that T and C's root problems for their relationships were: 

□ T's attachment to his parents, especially to his mother was stronger than his 
attachment to C, impacting how T made decisions among them and 
contributing to C's insecurity in her relationship with T 

□ T's rational judging and practical thinking personality toward C made C felt 
uncomfortable and unloved because C was longing for love and care. 

We discussed Genesis 2:18-24, Ephesians 5:22-33, and Romans 15:1-6 in detail. I 
asked them to consider what God said and prayed that they would apply these verses in 
their relationship with their parents and spouse. 

At the end of the session, I assigned homework that required them to find a 
quiet time to talk to each other about the root problems and to seek forgiveness. 

Session 7 

According to the treatment plan, during the seventh session, the objectives 
included a homework review and a sharing of how relevant Bible verses help to solve 


69 



each root problem. Think about what is old self and how old self could die from a 
Romans 6's perspective was the homework before the next session. 

At the beginning of the session, we reviewed the homework: 

T: C's reaction to T was calmer, and it was easier for T to communicate with her. 
Therefore, T's attitude toward C was more peaceful and showed more love and care. 

C: C had more faith in her relationship with T and felt more secure. When they 
had a conflict, C tried to see the conflict from a third person's perspective. So, she was 
more objective to look at T and herself. Then, C could be more rational to explain to T 
her feelings and asked for T's feelings. C also communicated to God more and thought 
about Bible verses which could be applied to her situation. C could consider future 
decisions not just from her own angle, but from other's, giving her burden to God. C 
changed her interaction patterns with T in many ways. 

The homework following this session required that they think about what is the 
old self, and how that old self could die according to Romans 6. In order to live a new 
life and renew an old attachment with significant others, the old self needs to die. There 
are two things a person must do in order to let the old self die. First, one needs to 
forgive others who hurt them in the past, in front of God. Second, one needs to seek 
forgiveness from persons whom he hurt in the past, and make restitution, if needed. 

Session 8 

The objectives for the eighth session, included a homework review and 
discussion about the role of forgiveness in the dying of the old self. 


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Their marriage relationship was improving, and they wanted to talk about a 


major decision they needed to make as soon as possible for their future: whether to 
stay in Beijing or move back to the U.S. They had been in Beijing for three years. In order 
for T to become a partner of his law firm, he needed to stay at the Beijing office for a 
longer period of time. T had another option to find a better job in Shanghai. One reason 
they moved back to China was to answer a calling to share the gospel with fellow 
Chinese in China. However, the church they attended was not open to their suggestions, 
and they felt they could not serve in ways they like. Plus, their older daughter was about 
to attend the elementary school, and the U.S. elementary schools were much better 
than the one in China. At last, it was about time for them to apply for the U.S. green 
card. 

I asked them to share their understanding of the pros and cons for each option, 
and which option was the one that might not happen in the future if they missed this 
time. T said that, for his career, to stay in the Beijing office would guarantee he would 
be promoted to the partner in the near future. If he moved back to the U.S., he needed 
to find another law firm and it would delay any promotion to be a partner in a firm. Plus, 
staying in Beijing and Shanghai would make it easy for him to take care of his parents. 

For C, the smog condition in Beijing and the difficult church were challenging not 
just for them, but also for their young daughters. Going back to the familiar Chinese 
church and better school in New Jersey with more suitable environments was better for 
the whole family than to remain in Beijing. 


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For their homework following this sessions, I requested that they examine these 


options not just for themselves, but for other family members. After a week, they told 
me that they decided to move back to New Jersey. 

Session 9 

The objectives for the ninth session, included the homework review, discussing 
each root problem and applying Romans 8 to help build new reaction patterns. 

We reviewed the homework from last session as follows: I asked T and C to think 
about their old selves and how their old selves could die based upon Romans 6. T and C 
had confessed to each other and sought forgiveness in sessions 6 and 7. C also forgave 
her grandmother and T's parents for their mean treatment of her in the past. C 
mentioned that since she and T had moved back to the U.S. for about half a year, T's 
parents hinted that it was about time to for them to apply for visas, again. Even though 
C had forgiven what they did to her, she still felt discomforting pressure when she 
thought about T's parents living with them again, expressing concern that T's parents 
would be dominant and intrusive to C's privacy as before. I told C that it was the right 
time to go through Romans 8 to learn how to let her new self grow. 

Studying Romans 8 together, we discuss how a person who loves God could 
benefit from everything that happened? We looked at this from three angles: 

1. In current "suffering", how could we wait patiently for the future glory? I told 
C that by being willing to satisfy T's parents' needs, she was choosing a way 
to show God's love and reflect God's glory. C could also seek God's wisdom 


72 



to wisely interact with T's parents in order to achieve mutual benefits. In 


addition, the Bible says that a spiritually strong person should help the 
spiritually weak person. If C believed she was stronger spiritually than T's 
parents, then she would be willing to sacrifice her rights and comfort for the 
goodness of T's parents. At the same time, if T thought he was stronger 
spiritually than C, then he should be willing to sacrifice his rights and comfort 
for the goodness of C. 

2. In current "weakness", how could we acknowledge the Holy Spirit's prayer 
help? Sometimes, the storms of life may become severe, to a point that C 
feels she could not stand any more. I reminded C that the Holy Spirit could 
help her by praying for her to get God's help and strength to persevere 
through the difficulties. 

3. In current "growth", how could we experience calling, justification, and 
glorification in God's will? The last thing I told them to remember was that a 
Christian's life was a journey to God's glory through calling, justification and 
glorification. They could continue to grow until they were perfect and a 
useful tool in God's hand, able to do every good thing. 

At the end of session, I asked them to apply what they learned that day to one or 
two interactions with family, colleagues, or coworkers, and to report their experiences 
during the next session. 


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Session 10 


The objectives of the tenth session, included the homework and wrap up the 
sessions. The final ongoing homework assignment was to use God's word in their heart 
to guide their everyday life. 

C mentioned that, in the past, she would give in to T's parents' requests because 
they tended to be more dominant, and she did not want any conflict. After therapy, she 
could communicate better with T, was more confident, and could present her thoughts 
to T's parents and friends more calmly. In addition, she was more willing to sacrifice 
herself and be patiently kind to T's parents for T's sake. I encouraged her that this action 
meant she was suffering with Christ. 

T mentioned that while they lived in Beijing, in the Chinese church they served, 
the pastor's assistant was strong-willed and insisted on her ideas for church matters. T 
once had a different opinion while helping a young couple's marriage problem. She 
exchanged conversation and criticized T and C in an on-line group chat, even though T 
and C wanted to communicate with her in private and to reconcile with her. The 
assistant still preferred to settle this matter in the group chat. T and C were very 
frustrated because the situation did not improve and they did not know what to do. 
They asked me what they could do next, according to Romans 8. 

I told them that if they had done all they could do by obeying God's commands, 
and the situation still did not improve, they could think about what lessons God 
intended to teach them through this circumstance. This might be God's purpose by 
letting them go through the trial. In the trial, we may feel very weak, but remember that 


74 



Holy Spirit can help us, and reminding us that we are going through a glorification 
process. They later told me that they better understood the "new self" described in 
Romans 8 after my explanation. 

At the end of the session, I encouraged them to apply Romans 8 to every 
interaction in their life in order to live out the new life as described in 2 Corinthians 
5:17, "Therefore, if anyone is in Christ, he is a new creation; the old has gone, the new 
has come!" 


Important Learning Factors 

The first factor I learned from counseling T and C was that, when counseling 
Chinese-American couples, the parents' influence is a dominant factor which cannot be 
ignored by the therapist. In traditional Chinese culture, children are parents' property. 
They are never separated, even when they get older and marry. This is why traditional 
Chinese families with the same ancestors live in a large square house with a central 
courtyard. Marriage is arranged by parents and the daughter-in-law is expected to obey 
the mother-in-law without question. In addition, a mother tends to have a very strong 
emotional tie to her sons, especially to an only son, because Chinese fathers do not 
often have a healthy attachment to the mother. So, the son plays his father's role to his 
mother in many Chinese families. These kinds of attachments are reflected in T and C, 
with T's parental relationships to various degrees. 

Second, I learned that mental disease is similar to physical disease; healing outer 
symptoms may not cure inner root problems. Still, for the patient's sake, easing the pain 


75 



of the outer symptoms is the first step. Then, the patient may be ready for a lengthy 


therapy to cure the inner root problem. I started the therapy for T and C by asking about 
the three most troubling problems in their relationship, and I let them express their 
feelings to help cure their pain. Helping T and C express their inner feelings and 
thoughts on problems provided them the opportunity to release the pain and look at 
their problems from a new and deeper perspective. Chinese culture encourages proper 
manners and discourage excessive feelings. T tended to judge C's behavior before 
understanding her thoughts and feelings, which meant C did not have a chance to 
express her thoughts and had to repress her feelings. The beginning sessions focused on 
understanding the symptoms of their problems. The later sessions focused on the 
discovery and solutions their root problems. 

Third, I learned that as a Christian, the old self dies with Christ on the cross when 
one is baptized. Yet, many Christians do not know this teaching in Romans 6, or they do 
not know how to let the old self die. In order for the old self to die, one needs to do two 
things: 1) forgive persons who have hurt him/her in the past, 2) seek forgiveness from 
persons whom he/she has hurt in the past. T had not experienced hurt by others since 
his youth, but his strong-will and attitude of superiority hurt C and others beneath his 
notice, for which he needed to seek forgiveness from C and others. C was hurt by her 
grandmother and father, and she needed to forgive them. Once they take these two 
steps, they can begin to start their new life with the Holy Spirit as their guide. 

When our right is denied by others, or things we deserve are taken away by 
others, our hearts can become ruled by anger, anxiety, disappointment, and bitterness. 


76 



Time and energy may be spent to get our rights back or take revenge. Clearly, in C's 
case, we can see some of these happened. Romans 8 teaches that a person who loves 
God can benefit from every circumstance, and as a mature Christian who loves God, will 
receive glory when willing to suffer with Christ. For the goodness of others, when we 
give up our right and give in to others 1 views and ways, the Holy Spirit can help us in 
prayer, and we can walk the road to our final rewarding glory through our calling, 
justification, and glorification by God. At the same time, I advised C to wisely negotiate 
with T's parents to set boundaries with a loving attitude whenever she can. In later 
sessions, T is willing to consider C's needs more than his for Christ, and C is willing to 
consider T and T's parents' needs more than her own for Christ. These actions 
demonstrate how a spiritually strong Christian can strengthen the spiritually weak one. 

My Own Growth Pattern 

My wife, Elaine, and I met each other in 1973 and married in 1977. At that time, 
she was a sweet, talkative, kind, and extroverted lady, and I was gentle, quiet, 
intellectual, and introverted. When we were friends, we got alone very well and liked 
each other very much. She was very considerate of my needs and took good care of me. 
Sometimes, I felt I was spoiled. But after we married, our true preferences and ways of 
doing things emerged. Because of these differences, our relationship was tense at times 
and our interaction seemed to move into a negative cycle often. 

After I began to study and practice counseling in 2009, I tried to apply what I 
learned to my own marriage, consciously and unconsciously and found our interaction 


77 



pattern was not healthy. As a consequence, our relationship became more and more 


distanced. At that time, Elaine and I had counseled many couples in pre-marriage and 
marriage. Some cases were quite successful. But for my own marriage, I could not 
resolve our conflicts, even after I entered the D.Min. program in 2013. This made me 
think that if I was supposed to be a marriage expert after graduation, why could not I 
counsel my own marriage? So, I started to use the same counseling treatment 
methodology on my own marriage. 

I started with our most troubling problems of our marriage, examined our 
primary family influences. I realized our old selves were not dead. We discussed our 
histories and decided to forgive the ones who hurt us in the past in prayers to God, and 
we sought forgiveness from one another. In order for our new selves to live, I decided to 
accept Elaine as she was, as God accepted me, a sinner with many sins. I expected her to 
change to be like Christ after so many years as a Christian. Even though she is not, I am 
willing to sacrifice my right so that I could suffer with Christ. I know when I do this, I am 
on the road to the final rewards through calling, justification and glorification with the 
Holy Spirit's help. When I meditate on God's abundant love toward me, my attitude and 
behavior toward Elaine change, and she changes also. 

Biblical counseling combines the beauties of secular psychological therapy and 
biblical theological methodology. Psychological therapy allows the therapist to look 
clearly on client's problems in old self from the outermost behavior to the innermost 
perception, and the theological methodology guides the client to reach a lasting and 
complete biblical solution in new self from inner perception to outermost behavior. This 


78 



thesis is tailored for counseling young Chinese-American couples to live happily within a 
godly marriage. 


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BIBLIOGRAPHY 


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VITA 


Joseph Tso-Yuan Wang 

Born in 1951 

Married to Elaine Wan 

Two daughters: Lin-Fan and Lin-Chi 

Graduated from Tunghai University with a bachelar degree in 1976 

Graduated from University of Texas at Arlinton with a MS degree in 1984 

Graduated from Western Michigan University with a PhD candidate degree in 1999 

Graduated from Biblical Theological Seminary with a MDiv degree in 2009 

Working on a DMIN program at Gordon Conwell Theological Seminary and will graduate 

in May 2017 

Worked as a programmer from 1984 to 1994 

Worked as a statistician from 1994 to 2003 

Worked as an Associate statistical director from 2003 to 2009 

Worked as a statistical director from 2009 to 2013 

Worked as a church minister from 2013 to 2016 

Worked as a seminary chaplain from 2016 to now 


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